Pediatric pulmonology · 2025
Gender Differences in Mental Well-Being Among Children and Adults With Cystic Fibrosis in the Modulator Era.
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Georgiopoulos Anna M, Van Citters Aricca D, Brown Cynthia D, Yu Elizabeth, Zagnit Emily A, Aliaj Enid, King Joel R, Kazmerski Traci M
Аннотация
BACKGROUND: Females with cystic fibrosis (CF) experience worse health outcomes than males. Given this sex disparity, we examined the impact of gender on mental health-related quality of life (QoL) and mental well-being among people with CF (PwCF).
METHODS: We used Wellness in the Modulator Era (Well-ME) survey data from 587 adults and 275 parents/caregivers providing proxy report for children to identify gender differences in mental health-related QoL on PROMIS measures and reported changes in mental well-being since CFTR modulator initiation or in the last 12 months. We used standard statistical tests to identify gender differences, with significance corrected for multiple comparisons using the Benjamini-Hochberg method. Thematic and content analyses identified mental well-being themes.
RESULTS: There were no gender differences in mental health QoL, but women more often reported worsening mental well-being than men (33% vs. 18%; p < 0.001). Among PwCF taking modulators: Women more often experienced somewhat/much worsened overall mental health, anxiety, depression, agitation/irritability, stress, body image, thinking clearly and guilt since modulator initiation than men; girls more often experienced worsened anxiety, depression, stress and acting out than boys; men more often reported worsened alcohol/drug use than women.
CONCLUSIONS: Our findings align with general population data showing women/girls at higher risk for depression, anxiety, and body dissatisfaction than men/boys, and substance use more common in men/boys. Additional research is needed to determine to what extent and via which mechanisms gender disparities may affect mental well-being, to inform strategies to mitigate risks following modulator initiation, and to improve mental health of PwCF.
METHODS: We used Wellness in the Modulator Era (Well-ME) survey data from 587 adults and 275 parents/caregivers providing proxy report for children to identify gender differences in mental health-related QoL on PROMIS measures and reported changes in mental well-being since CFTR modulator initiation or in the last 12 months. We used standard statistical tests to identify gender differences, with significance corrected for multiple comparisons using the Benjamini-Hochberg method. Thematic and content analyses identified mental well-being themes.
RESULTS: There were no gender differences in mental health QoL, but women more often reported worsening mental well-being than men (33% vs. 18%; p < 0.001). Among PwCF taking modulators: Women more often experienced somewhat/much worsened overall mental health, anxiety, depression, agitation/irritability, stress, body image, thinking clearly and guilt since modulator initiation than men; girls more often experienced worsened anxiety, depression, stress and acting out than boys; men more often reported worsened alcohol/drug use than women.
CONCLUSIONS: Our findings align with general population data showing women/girls at higher risk for depression, anxiety, and body dissatisfaction than men/boys, and substance use more common in men/boys. Additional research is needed to determine to what extent and via which mechanisms gender disparities may affect mental well-being, to inform strategies to mitigate risks following modulator initiation, and to improve mental health of PwCF.