Brief Interventions With Patients With Cystic Fibrosis (CF) And Caregivers Who Score Symptomatically On The PHQ-9 And GAD-7
BACKGROUND: Initial screening of patients with cystic fibrosis (CF) and their caregivers showed approximately half of patients and caregivers experience symptomatic levels of anxiety and depression based on the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7). Brief interventions designed to reduce symptoms were implemented.
METHODS: CF patients aged 12 to adult, and caregivers were screened from 2016-2018. Symptomatic patients and caregivers (scores >5) were asked to discuss the symptoms endorsed, and whether or not they were receiving mental health services. Brief interventions (i.e., solution-focused) were discussed based on the presenting symptoms. Each of these interactions were detailed and later categorized: brief intervention (e.g., sleep hygiene, behavioral activation, supportive therapy, anxiety reduction, behavioral planning), discussing community therapeutic services, referrals, psychotropic medications, and education.
RESULTS: In the 30 months of screening, 603 total GAD-7 and PHQ-9 screens were completed. Sixty-six (66) individuals were screened with the GAD-7 and the PHQ-9, some were screened more than once. Patient screening improved to 86%. Of those patients and caregivers who scored symptomatically (10 and 27, respectively), brief interventions (n=55) were followed by a decrease in reported symptoms. Education decreased severity in 80% of patients and 29% of caregivers, while psychotherapy did the same in 50% of patients and 40% of caregivers.
CONCLUSION: These data suggest that brief interventions may contribute to decreased symptoms of anxiety and depression. Education seems to work in patients while psychotherapy may be required with caregivers. These data support the integration of behavioral health interventions into CF Clinics.