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Screening for ADHD in adults with cystic fibrosis: Prevalence,health-related quality of life,and adherence
Authors:Anna M. Georgiopoulos  Deborah Friedman  Elizabeth A. Porter  Amy Krasner  Sheetal P. Kakarala  Breanna K. Glaeser  Siena C. Napoleon  Janet Wozniak
Affiliation:1. Department of Psychiatry (Child and Adolescent Psychiatry), Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA;2. Cystic Fibrosis Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA;3. Department of Social Service, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA;4. Chair, Quality and Safety, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
Abstract:

Background

International guidelines recommend depression and anxiety screening in individuals with cystic fibrosis (CF), but Attention-Deficit Hyperactivity Disorder (ADHD) remains understudied.

Methods

Adults with CF (n = 53) were screened using the Adult ADHD Self-Report Scale-v1.1 Symptom Checklist (ASRS-v1.1), Cystic Fibrosis Questionnaire-Revised (CFQ-R), and a self-report measure of treatment adherence.

Results

Elevated ADHD symptoms on the ASRS-v1.1 screener were reported by 15% of participants. Self-reported adherence, Body Mass Index in kg/m2 (BMI), and Forced Expiratory Volume in 1 Second, Percent Predicted (FEV1%pred) did not differ between participants with vs. without elevated ADHD scores. Three CFQ-R scales, Physical Functioning, Role Functioning, and Respiratory Symptoms, were significantly lower in participants with elevated ADHD screens (unadjusted p < 0.05). This difference remained statistically significant for the Role Functioning and Respiratory Symptoms scales following correction for multiple comparisons.

Conclusions

The highly specific screening tool ASRS-v1.1 can ascertain previously undetected ADHD symptoms in adults with CF. ADHD was substantially more prevalent than expected in this population. Elevated ASRS-v1.1 screens correlated with poorer Health-Related Quality of Life (HRQoL) in some domains, but not with BMI, FEV1%pred, or self-reported CF treatment adherence. Additional research will elucidate the impact of ADHD and its treatment on HRQoL, CF self-care and health outcomes.
Keywords:ADHD  Attention-Deficit Hyperactivity Disorder  ASRS-v1.1  Adult ADHD Self-Report Scale-v1.1 symptom checklist  BMI  CES-D  Center for Epidemiologic Studies Depression scale  CF  Cystic fibrosis  CFQ-R  Cystic Fibrosis Questionnaire-Revised  CFTR  Cystic Fibrosis Transmembrane Conductance Regulator  FEV1%pred  Forced Expiratory Volume in 1 Second, Percent Predicted  HADS  Hospital and Anxiety Depression Scale  HRQoL  Health-Related Quality of Life  MGH  Massachusetts General Hospital  TIDES-CF  The International Depression Epidemiological Study  Cystic fibrosis  Attention-deficit hyperactivity disorder  Health-related quality of life  Adherence
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