J Cyst Fibros. 2026 Mar 25:S1569-1993(26)00082-2. doi: 10.1016/j.jcf.2026.03.015. Online ahead of print.
ABSTRACT
BACKGROUND: Coping and Learning to Manage Stress with CF (CALM) is a manualized intervention for adults with cystic fibrosis (AWCF). A unique feature of the CALM multisite randomized controlled trial (RCT) was the inclusion of individuals with severe symptoms of depression and/or anxiety, including those endorsing suicidal ideation. Post-hoc analyses examined the extent to which those with severe symptoms benefited from CALM.
METHODS: Analyses included 121 AWCF who participated in CALM and provided evaluable depression (Patient Health Questionnaire; PHQ-9) and/or anxiety (Generalized Anxiety Disorder-7; GAD-7) data. Established cut-points classified participants into four symptom severity groups (normal, mild, moderate, severe) for both depression and anxiety before participating in CALM. Linear mixed models examined mean depression and anxiety scores across severity groups at 4 time points: pre-CALM, post-CALM, 1-month follow-up, and 3-month follow-up.
RESULTS: Pre-CALM depression severity ranged from normal (n = 24) to severe (n = 11), with most participants reporting mild (n = 57) or moderate (n = 29) symptoms. Anxiety severity followed a similar distribution (normal=18; mild=59; moderate=27; severe=16), and 9% of participants reported suicidal ideation. AWCF reporting severe depression and/or anxiety symptoms before starting CALM showed statistically significant reductions in both depression and anxiety at the post, 1-month follow-up, and 3-month follow-up (p<.0001 for each comparison with the pre-CALM time point).
CONCLUSIONS: AWCF with severe depression and/or anxiety symptoms showed significant symptom improvement following participation in CALM. This RCT is first to provide evidence of the efficacy of a stress management intervention to effectively treat severe depression and anxiety symptoms in AWCF.
PMID:41887978 | DOI:10.1016/j.jcf.2026.03.015
