Impact of UPLIFT, a group telehealth intervention, on symptoms of depression and anxiety in adults with CF

Michael S Schechter; Andrea Molzhon; Robin S Everhart; Le Kang; Rachel Weiskittle; Brittany Castleberry; Nancy J Thompson

doi:10.1016/j.jcf.2024.11.008

Impact of UPLIFT, a group telehealth intervention, on symptoms of depression and anxiety in adults with CF

J Cyst Fibros. 2024 Dec 11:S1569-1993(24)01846-0. doi: 10.1016/j.jcf.2024.11.008. Online ahead of print.

Authors

Michael S Schechter¹, Andrea Molzhon², Robin S Everhart³, Le Kang⁴, Rachel Weiskittle⁵, Brittany Castleberry⁶, Nancy J Thompson⁷

Affiliations

¹ Children's Hospital of Richmond at Virginia Commonwealth University, Richmond VA, USA. Electronic address: mschechter@vcu.edu.
² Children's Hospital of Richmond at Virginia Commonwealth University, Richmond VA, USA. Electronic address: andrea.molzhon@vcuhealth.org.
³ Children's Hospital of Richmond at Virginia Commonwealth University, Richmond VA, USA. Electronic address: reverhart@vcu.edu.
⁴ Virginia Commonwealth University School of Public Health, Richmond, VA, USA. Electronic address: lkang@vcu.edu.
⁵ University of Colorado, Colorado Springs, CO, USA. Electronic address: rweiskit@uccs.edu.
⁶ No institutional affiliation. Electronic address: bkweld1545@gmail.com.
⁷ Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: nthomps@emory.edu.

PMID: 39668003
DOI: 10.1016/j.jcf.2024.11.008

Abstract

Background: Despite high rates of anxiety and depression, research regarding the effect of psychological interventions on people with CF (pwCF) is limited. We evaluated the impact of UPLIFT (Using Practice and Learning to Increase Favorable Thoughts), a group telehealth intervention using mindfulness-based cognitive behavioral therapy (MBCT), on symptoms of anxiety and depression in pwCF.

Methods: This multicenter randomized trial compared changes in symptoms of anxiety and/or depression in adult pwCF who participated in the 8-week UPLIFT intervention to a treatment-as-usual (TAU) group. Follow up assessments occurred immediately after and 6- and 12-months post-intervention. Primary outcome measures were change in Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scores modeled in separate linear mixed-effects models.

Results: Sixty-six pwCF participated. At baseline, 43 (65.15%) had some minimal symptoms of depression (PHQ-9≥5) and 44 (66.67%) had some minimal symptoms of anxiety (GAD-7≥5). During the 12 month follow up period, the overall change in PHQ-9 was greater in the UPLIFT group compared to TAU (p = .049). Analysis of individual time points showed a statistically significant difference between groups in change from baseline immediately post-treatment (-2.321, SD 0.684 vs 0.362, SD 0.656, p = .005); differences persisted but were not statistically significant at 6 and 12 months. Similar trends for changes in GAD-7 were non-significant.

Conclusions: Participation in UPLIFT, a group telehealth intervention using MBCT, provides short-term improvement in symptoms of depression, as measured by changes in PHQ9. Improvement in symptoms of anxiety were suggested but could not be statistically confirmed.

Keywords: Anxiety; Cognitive behavioral therapy; Cystic fibrosis; Depression; Mindfulness; Telehealth.