Cystic fibrosis (CF) is a genetic illness with multi-system involvement. While CF continues to shorten survival, new therapies have broadened CF from a pediatric disease to one affecting individuals and families at all developmental stages, in multiple domains of functioning. Depression and anxiety are 2-3 times elevated in adolescents and adults with CF and parent caregivers (Quittner A et al, 2014). Depression in CF is associated with decreased quality of life, increased healthcare costs, poorer adherence to CF care, and worsened medical outcomes, including mortality. In response, the CF Foundation (CFF) and European CF Society (ECFS) created international guidelines on screening, addressing, and preventing depression and anxiety, along with comorbid conditions, via flexibly-designed integrated mental health care within CF clinics (Quittner A et al, 2015). This unique model demonstrates how mental health clinicians, including CL psychiatrists, can be fully embedded with the multidisciplinary team throughout the lifespan of individuals with CF. The symposium will highlight aspects unique to CF and discuss how the CF experience can guide the future of CL psychiatry in modeling successful changes in culture, systems of care, and longitudinal collaboration with subspecialty medical teams.
In this presentation, Dr. Anna Georgiopoulos will review the epidemiology and impact of psychiatric disorders in individuals with CF and parent caregivers. She will discuss key information needed for CL psychiatrists to optimize psychiatric management of mood disorders, anxiety, ADHD and substance misuse in the context of a rapidly changing CF medical landscape, including novel CF therapies. (20 minutes)
Dr. Beth Smith will discuss the creation CFF/ECFS care guidelines to increase ascertainment and mental health service delivery and through a systems lens discuss how these guidelines have been disseminated and implemented throughout CFF-accredited centers and the CF community across the US, with parallel efforts in Europe and Australia. She will describe how the roles and perceptions of mental health clinicians, including CL psychiatrists, have changed. She will delineate the increasing centrality of emotional wellness to the CF care model, with prevention, early intervention, and a family systems approach starting at the time of newborn screening, and extending through childhood and adolescence into adult care. (20 minutes)
Dr. Sher will discuss a particular example of an embedded CL psychiatrist within an adult CF clinic. She will describe the role of the psychiatrist, including collaborations with team members (i.e., NPs, pulmonologists, dieticians, social workers) to assist patients throughout their medical journey, starting with transition from pediatric to adult CF center , through assessment and waiting for transplant, and incorporation of palliative care and hospice. (20 minutes)
Throughout the presentation, case examples will be used to demonstrate important points, facilitate discussion, and encourage audience participation. Dr. Catherine Crone will moderate the discussion. (30 minutes).