Parental depression following the early diagnosis of cystic fibrosis: a matched, prospective study.

Abstract

To assess risks for parental depression following the diagnosis of cystic fibrosis (CF) in a child. Matched cohort study in NW England; 45 parental couples with a child diagnosed with CF were compared with 45 control couples matching for age, sex, and position in the family of the index child. The Beck Depression Inventory (BDI-II) with a clinical cut-off > or = 13 for dysphoria (mild depression) was the main outcome. A stratified analysis was conducted using the Mantel-Haenszel risk-ratio estimator (RR(MH)) with eight strata for each of the matching variable combinations. Heterogeneity was found within the dataset. Parents with a child with CF < or = 9 months of age at baseline had an elevated prospective risk of depression (mothers RR(MH) [95% confidence interval (CI)] = 2.6[1.05,6.42], fathers RR(MH) [95%CI] = 2.26 [0.97,5.28]). The absence of a group effect for depression at follow-up after adjusting for the matching (mothers RR(MH) [95%CI] = 1.1 [0.59,2.05], fathers RR(MH) [95%CI] = 1.42 [0.66,3.08]) masked this heterogeneity. This hypothesis-generating finding suggests that parents may be more vulnerable to depression when their child is diagnosed with a life-shortening condition during the first few months of life. Mood in parents of infants diagnosed early needs to be monitored longitudinally and preventative strategies devised.