ADHD in Cystic Fibrosis: Prevalence, Screening, and Treatment

A study of adult patients with cystic fibrosis (CF) is the first of its kind to document that symptoms of attention-deficit/hyperactivity disorder (ADHD), which are common in this population, can be readily detected using short, specific, and easily accessible adult ADHD screening tools. Findings were published in the Journal of Cystic Fibrosis.

A total of 53 adults with CF were evaluated using the following tools: the Adult ADHD Self-Report Scale-v1.1 Symptom Checklist (ASRS-v1.1), the Cystic Fibrosis Questionnaire-Revised (CFQ-R), and a self-report assessment of treatment adherence. The ASRS-v1.1 is a widely available, 18-item measure that includes a 6-item screener with the items most predictive of ADHD. The CFQ-R is a CF-specific measure of health-related quality of life (HRQoL).

The mean age of the 53 participants was 34.6±11.2 years; 49% of the patients were men. Overall, 15% of the participants reported elevated ADHD symptoms on the ASRS-v1.1 screener. Forced expiratory volume in 1 second percent predicted (FEV₁ %pred), body mass index (BMI), and self-reported treatment adherence all did not differ significantly between the participants with and without elevated ADHD scores. Elevated ASRS-v1.1 screens were associated with poorer HRQoL in some domains, but not with FEV₁ %pred, BMI, or self-reported CF treatment adherence.

Three CFQ-R scales — Physical Functioning, Role Functioning, and Respiratory Symptoms  — were all significantly lower in the participants with elevated ADHD scores (unadjusted P <.05). After correction for multiple comparisons, this difference remained statistically significant for the Role Functioning and Respiratory Symptoms scales.

The investigators concluded that the ASRS-v1.1 can discern previously undetected ADHD symptoms in adults with CF. In fact, ADHD was considerably more prevalent than expected in the population examined. Further research is warranted to confirm the prevalence of ADHD in adults with CF following a full diagnostic evaluation, and to help elucidate the effect of ADHD and its treatment on CF self-care, HRQoL, and health outcomes.

Reference

Georgiopoulos AM, Friedman D, Porter EA, et al. Screening for ADHD in adults with cystic fibrosis: Prevalence, health-related quality of life, and adherence [published online August 31, 2017]. J Cyst Fibros. doi:10.1016/j.jcf.2017.08.011