Background: People with CF (pwCF) frequently have gastrointestinal symptoms (GI), including abdominal pain and irregular bowel movements. These are often embarrassing, difficult to report, and frequently missed. Thus, a GI Symptom Tracker was created and validated in the US and translated and validated in Dutch. This questionnaire consists of four subscales: Eating Challenges, Stools, Adherence Challenges and Abdominal Symptoms. Aim of this study was to investigate the relationship between GI symptoms, anxiety/depression and health-related quality of life (HRQoL) in Dutch pwCF. Methods: In this prospective, cross-sectional single-center pilot study, pwCF completed the Dutch GI Symptom Tracker, GAD-7 (anxiety), PHQ-9 (depression), and CFQ-R (HRQoL) from Sept 2021-June 2022. Regression analyses were used to analyze the univariable associations between GI symptoms, anxiety/depression and HRQoL. Results: 51 pwCF were enrolled consecutively ( n= 41 adults, 66% female, mean age (y) [range]= 32.7 [19-71] & n=10 adolescents, 70% female, mean age (y) [range]= 14.2 [12-17]). Elevated levels of anxiety (scores ≥10 on GAD-7) were found in 17% of adults and 0% of adolescents. Elevated depression scores ( ≥10 on PHQ-9) were found in 9% of adults and 20% of adolescents. GI scales ‘Eating Challenges’ and ‘Stools’ were significantly, positively associated with elevated symptoms of anxiety and depression. Most GI scales were associated with lower HRQoL. Conclusion: This is the first study investigating the link between GI symptoms assessed by the Dutch GI Symptom Tracker and anxiety/depression and HRQoL in Dutch pwCF. More GI symptoms were associated with higher anxiety and depression scores and worse health-related quality of life. Additional research is needed to better understand how mental and physical health are linked in CF.

Introduction: COVID-19 emerged in China leading to worldwide morbidity and mortality, including depression and anxiety. As the pandemic spread throughout Italy and Europe, mental health concerns emerged for people with cystic fibrosis (pwCF), who are at increased risk. This led to development of a Telehealth Psychological Support Intervention to help adolescents/young adults with CF and caregivers cope with the stress and emotional challenges of the lockdown which began in Italy in March 2020. Methods: This intervention utilized cognitive behavioral skills (e.g., relaxation training, cognitive reframing). Participants included 16 adolescents/adults and 14 parents, who completed 4 individual video sessions with a psychologist. Stress ratings, PHQ-8 and GAD-7 were completed electronically. Feasibility and Satisfaction were rated. Results: Ratings of stress significantly decreased from pre to post-testing for both pwCF (paired t=-4.06 (14), p<.01) and parents (paired t=-5.2, p< 001). Most participants reported clinically elevated depression and anxiety at the pre-test, with statistically significant reductions in depression for pwCF (pre: M=8.0 to post M=4.7; paired t (14)=2.8, p <.05) but not anxiety (pre: M=6.9 to post: M=5.6, t (14)=1.2, p=NS). Reductions in depression were found for parents (pre: M=6.4 to post: M 5.1, (14) t=-2.5, p<.05) but not anxiety (pre: M=8.1 to post: M=7.9, t (14)=-0.2, p=ns). Positive ratings of Feasibility and Satisfaction were documented. Conclusion: This brief telehealth intervention yielded significant reductions in stress and depression for participants. Anxiety was not reduced, possibly because COVID was ongoing. This intervention was effective for improving mental health and was highly feasible and satisfactory.