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Anxiety in Children with Cystic Fibrosis and Their Parents: A Systematic Review

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Abstract

Individuals with cystic fibrosis (CF) are at high risk of clinically significant anxiety, which can be related to lower treatment adherence and poorer health outcomes. Additionally, up to half of the parents/caregivers of children with CF experience clinically significant anxiety. Research has focussed on CF youth aged 13 years and older, leaving anxiety among school-aged children (aged 6–12 years) largely unstudied. This review aimed to synthesize research on anxiety among children with CF and their parents, examining prevalence, risk factors, and relationships between parent and child factors. Four electronic databases were searched, and publications were included if participants were children (or parents of children) with CF with a mean age between 6 and 12 years, and a standardized anxiety measure was used. Data from fourteen studies were extracted for descriptive synthesis; however, no studies focussed exclusively on the age range of 6–12 years. Results generally indicated that anxiety is highly prevalent in both child and parent populations; anxiety was the most prevalent mental health condition among children with CF, and anxiety was higher among CF populations than control populations among both children and parents. However, there were disparities, with some papers finding low rates of anxiety, and results on the relationship between anxiety and health outcomes varying greatly. Several risk factors were identified, but few were corroborated. There is an overall deficiency of research in this area, particularly examining the relationships between parent and child anxiety, and anxiety and health outcomes. Further research on suitable screening and intervention practices is also required.

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Notes

  1. Abbott (2003), Baiardini et al. (2015), Biesecker and Erby (2008), Christian (2003), Cousino and Hazen (2013), Cruz et al. (2009), Ernst et al. (2010), Glasscoe and Quittner (2003), Goldstein et al. (2013, 2014), Muther et al. (2018), Pinquart (2018), Quittner et al. (2016), Santer et al. (2014) and Thabrew et al. (2018).

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Acknowledgements

The authors thank Kate Hatchman for her assistance as the secondary screener.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. School of Psychology, The University of Queensland, Level 3, McElwain Building (24A), St Lucia, Brisbane, QLD, 4072, Australia

    Hayley Kimball, Matthew Sanders & Vanessa E. Cobham

  2. Cystic Fibrosis Service, Queensland Children’s Hospital, Brisbane, Australia

    Tonia Douglas

  3. School of Medicine, University of Queensland, Brisbane, Australia

    Tonia Douglas

  4. Child and Youth Mental Health Service [CYMHS], Children’s Health Queensland Hospital and Health Service, Brisbane, QLD, Australia

    Vanessa E. Cobham

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  1. Hayley Kimball
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  2. Tonia Douglas
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  4. Vanessa E. Cobham
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Contributions

All the authors contributed to the study conception and design. Database searches, screening, and analysis were performed by HK. The first draft of the manuscript was written by HK and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Hayley Kimball.

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Conflict of interest

Dr. Cobham and Prof. Sanders are the authors of Fear-Less Triple P, an intervention within Triple P—the Positive Parenting Program, which is developed and owned by The University of Queensland (UQ). Royalties are also distributed to the Faculty of Health and Behavioural Sciences at UQ and contributory authors of published Triple P resources. Triple P International (TPI) Pty Ltd. is a private company licensed by Uniquest Pty Ltd. on behalf of UQ, to publish and disseminate Triple P worldwide. Dr. Cobham and Prof. Sanders receive royalties and/or consultancy fees from TPI. TPI had no involvement in the study design, collection, analysis, interpretation of data, or writing of this report.

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Kimball, H., Douglas, T., Sanders, M. et al. Anxiety in Children with Cystic Fibrosis and Their Parents: A Systematic Review. Clin Child Fam Psychol Rev 24, 370–390 (2021). https://doi.org/10.1007/s10567-021-00345-5

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