Identification of factors determining anxiety, depression and aggression, with particular emphasis on pain in Polish adolescents and young adults with cystic fibrosis

Background
The prolonged survival of patients with cystic fibrosis leads to the search for predictors that determine their physical health and functioning in social and psycho-emotional areas, and allows for better understanding of the mutual interactions.

Objectives
The aim of the study was to assess the incidence of pain in patients with CF and clinical determinants of anxiety, depression and aggression.

Material and methods
The study covered 95 patients with CF aged 14–25 years. The analysis included: the intensity of pain (Numeric Rating Scale), the level of anxiety, depression and aggression (Hospital Anxiety and Depression Scale), the quality of sleep (Athens Insomnia Scale), FEV1 and BMI .

Results
42.1% (n = 40) of patients with CF experienced pain, mainly moderate (n = 18; 45%) and severe (n = 14; 35%). In these patients, significantly higher median anxiety scores (6 vs 4) and median depression scores (3.5 vs 2) were recorded than in subjects without pain. Factors considerably determining anxiety scores were AIS scores (ß = 0.56) and sex (ß = 0.22), while depression scores were determined by AIS scores (ß = 0.56), BMI (ß = -0.20) and pain intensity (ß = 0.20). In turn, sex (ß = 0.30) and AIS scores (ß = 0.19) had an influence on aggression scores.

Conclusions
Pain occurs in a large proportion of patients with CF. Factors determining emotional disorders in patients with CF are pain, female sex, quality of sleep and body weight. Anxiety, depression and aggression have always been accompanied by poorer sleep quality.