Depression and Anxiety in Cystic Fibrosis Patients and Parents

A recent study of over 6,000 cystic fibrosis patients 12 years through adulthood, and over 4,000 parents, found that depression and anxiety were two to three times more elevated in patients with cystic fibrosis (CF) and in parents of children with CF. Although depression and anxiety are common in CF, the stigma associated with mental health issues often make people less likely to talk to about them.

To address this issue, the Cystic Fibrosis Foundation (CF Foundation) announced newly developed guidelines for screening and treating depression and anxiety. These guidelines are not a mandate from the CF Foundation to care centers, and they recognize that it will take time and effort for care center teams to adopt the recommendations.

CHOC Children’s  —  one of only a few affiliated care centers of the CF Foundation in Southern California and the only CF treatment center in Orange County — is one of the first care centers to adopt the recommended guidelines. At CHOC, we understand that living with CF and other chronic diseases can be emotionally challenging. We also know that depression and anxiety can have negative effects on physical health and the ability to follow a recommended treatment plan.

Dr. Amy Harrison, CHOC pulmonologist and CF specialist.
Dr. Amy Harrison, CHOC pulmonologist and CF specialist.

“The psychology component of our cystic fibrosis program really makes CHOC stand out,” said Amy Harrison, pulmonologist and CF specialist at CHOC. “Our multidisciplinary approach allows our care team to manage all aspects of CF from diagnosis to physical and mental health.”

CHOC is committed to ensure that every child in Orange County has access to mental health treatment without stigma or barriers, and we are pleased to be a recipient of the CF Foundation’s grant, Implementation of the Depression and Anxiety Guidelines: Award for a Mental Health Coordinator. The grant was offered to qualified care centers and allows the CF Foundation to collect best practices and disseminate them among all care centers.

The grant provides CHOC the opportunity to have a psychologist at every CF clinic to help patients and families. They will provide annual screenings, evidence-based interventions and follow-up care for depression and anxiety, as well as develop a community referral network of mental health providers.

Guideline Recommendations

The guidelines propose that just as measuring height, weight and PFTs are part of CF care, screening and treating depression and anxiety should become a routine part of CF care too. The screening consists of completing a couple of short questionnaires and is completely voluntary.

Recommendations include:

  • All patients 12 years and older should receive annual screening for depression and anxiety.
  • Parents of caregivers of patients aged 0-17 years should be offered annual screening for depression and anxiety.
  • A stepped process for prevention, screening, assessment and intervention. This can include talk therapy, medication or a combination of the two.

Referral to the CHOC Cystic Fibrosis Center

When a child is diagnosed or is suspected to have CF, a referral to an accredited CF care center can ensure that the child gets diagnosed properly, lives a long and healthy life, and receives treatment based on the most advanced research available. With access to a full range of CHOC pediatric subspecialists, the CHOC Cystic Fibrosis Center offers a number of life-enhancing technologies and treatments.

Our multidisciplinary CF clinic includes a board-certified pulmonologist and gastroenterologist, respiratory and physical therapist, nutritionist, nurse specialists, social worker and a psychologist. An endocrinologist and other specialists are also available to attend the appointment, if needed. Genetic testing and counseling can also be provided.

If you have a patient diagnosed with CF, or who has symptoms of CF, a pre-referral sweat test can be ordered at CHOC to confirm the diagnosis and refer for treatment. (CF Foundation guidelines recommend diagnosis confirmation by an approved CF Foundation care center.)

For appointments, please call the Patient Access Center at 888-770-2462 (888-770-CHOC).

Complete the CHOC Children’s Specialists Pulmonology Referral Request form located at

Fax ALL pertinent medical records to 855-246-2329 (855-CHOC-FAX).

To speak with a CHOC Children’s Specialists in Pulmonology, please call 714-509-8622.

Why You Should be on Doximity

Often called the “Linkedin for doctors,” Doximity is considered the premier online professional network for physicians.  Doximity has created online CVs for each physician in the country, for which physicians just need to claim their profiles, verify/correct their credentials and add additional professional information.  The entire process is free and takes about 15 minutes.

Member Benefits

Physicians interested in their professional online reputations will find being Doximity members particularly helpful.  The network’s data powers the US News and World Report Doctor Finder, which is the most visited site—other than—for consumers looking up information about their physicians.

Doximity members are also invited to participate in the “Best Hospitals” reputation survey.  In fact, physicians who became members by Dec. 11, 2015 received online surveys for US News’ “Best Children’s Hospitals” in February 2016.  (Note, CHOC is listed as Children’s Hospital of Orange County and the Mission Viejo campus is listed as CHOC at Mission Hospital.)

Other benefits of being on Doximity include:

  • researching and connecting with other physicians;
  • keeping up with the latest medical literature. (Doximity provides members access to several hundred peer-reviewed medical journals and high-quality consumer media sources, including NPR, Wall Street Journal and New York Times. Articles appear in members’ feeds based on selected interests, reading habits and specialties.);
  • communicating with other members via a HIPAA-compliant messaging platform that is integrated with a free fax line that allows users to receive, sign and send faxes from their desktops or mobile devices;
  • earning free CME;
  • reviewing residency information;
  • and evaluating salary information by specialty and geographic area in the US.

Colleague Connect

CHOC is partnering with Doximity’s Colleague Connect, a physician marketing program designed to enhance the hospital’s brand reputation—and its doctors’ reputations— among the physician community. The program’s key element is having physicians serve as brand ambassadors (physicians prefer hearing from colleagues rather than hospitals).  CHOC’s marketing and communications department is partnering with physician leaders to create personal messages targeted to carefully chosen physician audiences.  The goal is to introduce the physicians and CHOC, and have the recipients add the physicians as colleagues on Doximity.

When physicians are added as colleagues, they are essentially placed in a physician’s personal network.  This means the physician and CHOC have preferred placement in that physician’s search, and information about the physician and CHOC are more likely to be viewed by the physicians with whom they are connecting.  According to Doximity, this can lead to enhanced reputation and increased referrals.

Taking an Active Role

If you’re interested in partnering with CHOC’s Marketing and Communications Department on the Colleague Connect program, please contact Mellisa Henry, marketing director, at  The program doesn’t require much of your time.  You do need to permit CHOC to send colleague requests on your behalf, and either review or—if so inclined—write the colleague introduction messages.  If you have additional questions, please contact Mellisa, who can also put you in touch with a practicing physician who leads the hospital partnership program at Doximity.



Doctors’ Day Celebrates CHOC Physicians

A recent Doctors’ Day celebration gave CHOC Children’s a formal occasion to recognize the hard work and dedication of its booth

Held April 8, the special luncheon themed “CHOC Docs Lift Us Up” included remarks from CHOC President and CEO Kim Cripe, who lauded the physicians for their commitment to CHOC’s mission and the families it serves.

Medical staff leadership received special recognition, as did several physicians who recently retired: Dr. Klane Hales, anesthesiology; Dr. Gary Jenkins, pediatrics; Dr. Eugene Litwer, pediatrics; and Dr. Daniel Weissberg, radiology.


The event also included a special recognition for physicians who recently passed away: Dr. Leonard F. Kellogg, pediatrics; Dr. Jeffry Katz, anesthesiology; Dr. Joe Corless, pediatrics; and Dr. Sherwin Gillman, allergy and immunology.



The 2016 Physician Engagement Survey will be held April 25-May 23, 2016 for CHOC physicians on our medical staff. Don’t miss this opportunity to provide CHOC with your valuable input, which will allow the organization to further strengthen and improve its programs and services, to better serve you and our children.

Please look for a survey invitation via email from Press Ganey, who is conducting the survey on behalf of CHOC. The email contains the survey link and your individually assigned password. Please be assured all individual responses and comments are confidential. Your responses will be consolidated and reported in aggregate.

In appreciation of completing the survey, all participants will be entered in a raffle for a chance to win one of the following prizes: gift card to The Resort at Pelican Hill; gift card to The Ritz-Carlton; gift card to Mastro’s Restaurants; and gift card to Amazon. One winner will be selected each week of the survey.

In addition, all physicians who complete the survey and submit the entry form, will receive two tickets to an Angels game.

We highly encourage your participation in this brief online survey. For questions, please contact Leslie Castelo, director, business development at CHOC, at 714-509-4329 or

Local Businessman Shares Why the CHOC Follies Is A Must-See Show!

Known as one of Orange County’s most unique and popular fundraisers, the CHOC Follies is back again with the newest musical production, “Carly and the Choco Factory: An Orange County Musical of Sweethearts, Swindlers and Swashbucklers!” benefiting CHOC Children’s.

Featuring a talented cast of local social and business leaders, who graciously donate their time rehearsing for the show and fundraising for CHOC, the humorous production promises to be a crowd pleaser yet again.

We talked to Michael Velasco, a new CHOC Follies cast member and vice president of fulfillment services at Meridian in Tustin, about the upcoming show.

CHOC Follies

Q: How did you get involved with the show? Why is this important to you?

A: I’ve been a long-time supporter of CHOC, and have worked as a partner with CHOC Marketing and Communications and the CHOC Foundation for many years. This is important to me because I care about people, especially children. We are a community and are all one family, and should help each other. The Meridian team and I like to support all the good work that CHOC does.

Q: What character will you play in the show?

A: I don’t play a main character, but participate in all group acts. I’m happy to support awareness of CHOC Follies and the philanthropic goals raised by the cast members. I’m in awe of the cast and their skill sets. We’ve been rehearsing since January, twice a week. This is new and challenging for me, but I’m having a good time!

Q: What is your favorite part of the show so far?

A: The cast and everyone involved. This is a group of genuinely great human beings. The cast camaraderie and support of each other are admirable. You can’t participate and fly solo. You have to trust in the directors and cast, and they have to trust in you. I’m humbled by and grateful for this experience.

Q: Who should come to the show?

A: Everyone – family, friends and coworkers!

Q: What’s going to surprise people about the show?

A: The CHOC Follies directors and cast do an outstanding job of creating a high-quality musical. It’s going to be an exciting performance. Come see us, make time to relax and recharge!

“Carly and the Choco Factory” will be held on March 31-April 2, at the Robert B. Moore Theatre at Orange Coast College, in Costa Mesa.

Purchase tickets and learn more here.  Or, call the CHOC Foundation at 714-509-8690.