Sunday, September 2, 2007

Are CF Patients More Prone to Psychological Problems?

Many individuals with chronic illness or disease are likely to experience emotional problems such as depression or anxiety. In many cases the nature of the chronic illness is the underlying cause of mood disorders. Poor physical health can lead to psychological distress, and vice versa. Determining the course of treatment in these cases requires that the patient and diagnosing physician work together to find a solution that address both the chronic illness and the distressing psychological issues in tandem.

In the case of cystic fibrosis (CF) patients, psychological function has been assesed, but with varying results. The medical community at large is still working to better understand the link between the biological and psychological aspects of how patients with CF cope in the face of an ever-progressing disease. Some studies suggest that as patients with CF age, the likelihood of emotional disturbance increase. This is possibly due to patients being forced to break new ground in world that had been previously explored by relatively few cystic fibrosis adults.

As the median survival rate, as reported by the Cystic Fibrosis Foundation, continues to increase, adults with CF find themselves in uncertain and untested territory. The stress and anxiety that occurs as a result is likely to contribute to psychosocial and/or psychological impairment. It was hypothesized, by Deborah L. Anderson, PhD; Patrick A. Flume, MD, FCCP; and Kristina K. Hardy, PhD in their article Psychological Functioning of Adults with Cystic Fibrosis that “the higher prevalence of psychopathology may be related to disease severity rather than chronologic age.” (Chest 2001;119;1079-1-84. DOI 10.1378/chest.119.4.1079). However, their study concluded that adults with CF do not demonstrate significant levels of depression, anxiety, or other psychopathology. The rate of clinical depression in their sample "was equivalent to that found in the general population."

The study goes on to qualify their results by stating that just because adults with CF do not, as a group, exhibit a higher propensity toward depression or anxiety, that is not to say that CF patients are all psychologically healthy. Other factors, such as family history of mental illness, or even external factors unrelated to cystic fibrosis (e.g.. loss of job, failed marriage, emotional trauma) may lead a CF patient to undergo psychological analysis and treatment.

One of the things that contributes to better mental and emotional health for CF patients is having a strong support system. Family members, spouses, friends and church involvement all provide excellent sources of encouragement for people who are facing the difficulties of day to day life with a chronic, incurable condition such as CF. For this reason, it is increasingly important for the CF Team to include a clinical social worker or psychologist as a means to assist those with CF who may be having trouble finding a support community.

Additional Resources:

Treating Depression in Patients with CF
Psychosocial Issues and CF
Psychosocial Aspects of Cystic Fibrosis (A Textbook for Medical Professionals)

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