Gender Differences in Mental Well-Being Among Children and Adults With Cystic Fibrosis in the Modulator Era

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).

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.

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.

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.