BACKGROUND The International Depression Epidemiological Study (TIDES) found elevated rates of screen positivity for depression and anxiety among individuals with cystic fibrosis (CF). Depression is associated with worse adherence and health-related quality of life in CF. We investigated the relationship with mortality. METHODS Subjects were untransplanted participants in TIDES 12+ years of age receiving care at one of 45 collaborating US CF care centers who completed the Hospital Anxiety and Depression Scale and/or Center for Epidemiologic Studies Depression Scale during a stable visit between 2006 and 2010. Clinical characteristics and mortality data were obtained from the CF Foundation Patient Registry. The association of a positive screen with 5-year survival was evaluated using Cox Proportional Hazards modeling. RESULTS Of 1005 eligible patients, 25% screened positive for depression and 34% screened positive for anxiety. Patients who screened positive for depression were more likely to be older, have a residual function mutation, public insurance, and more pulmonary exacerbations in the screening year. There were 96 deaths. The unadjusted 5-year Hazard Ratio (HR) for death among those with depression was 2.0; 95% CI (1.3, 3.0)]. When adjusted for predetermined potential confounders the HR for the entire population was 1.4; 95% CI (0.9, 2.2). The adjusted HR was higher in adults [1.6; 95% CI (1.0, 2.4)] and those screening in the severe range [2.0; 95% CI (1.2, 3.4)]. Anxiety was not associated with mortality. CONCLUSIONS A positive depression screen is associated with increased mortality among adults with CF. Research into the etiology of this relationship is needed.

中文翻译：

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抑郁症筛查阳性的囊性纤维化患者的存活率降低

背景 国际抑郁症流行病学研究 (TIDES) 发现囊性纤维化 (CF) 患者的抑郁症和焦虑症筛查阳性率升高。抑郁症与 CF 患者较差的依从性和健康相关的生活质量有关。我们调查了与死亡率的关系。方法 受试者是 12 岁以上 TIDES 的未移植参与者，他们在 45 个合作的美国 CF 护理中心之一接受护理，他们在 2006 年至 2010 年的稳定访问期间完成了医院焦虑和抑郁量表和/或流行病学研究中心抑郁量表。特征和死亡率数据来自 CF 基金会患者登记处。使用 Cox Proportional Hazards 模型评估阳性筛查与 5 年生存率的关联。结果 在 1005 名符合条件的患者中，25% 的抑郁症筛查呈阳性，34% 的焦虑筛查呈阳性。筛选出抑郁症阳性的患者更可能年龄较大，有残存功能突变，有公共保险，并且在筛选年出现更多肺部疾病恶化。有96人死亡。抑郁症患者未调整的 5 年死亡风险比 (HR) 为 2.0；95% 置信区间 (1.3, 3.0)]。当针对预先确定的潜在混杂因素进行调整时，整个人群的 HR 为 1.4；95% 置信区间 (0.9, 2.2)。调整后的 HR 在成人中更高 [1.6; 95% CI (1.0, 2.4)] 和那些在严重范围 [2.0; 95% 置信区间 (1.2, 3.4)]。焦虑与死亡率无关。结论 抑郁筛查阳性与 CF 成人死亡率增加有关。