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Background COVID-19 is an emerging issue that has significant consequences on psycho-social well-being. Methods In this regard, a survey was conducted on a large group of adolescents in Italy. The survey investigated four items: concerns and fears, information on the pandemic, provisions of public authorities (e.g., lockdown), and impact on everyday life. Results Adolescents actively participated in the survey. COVID-19 affected emotions and lifestyle. COVID-19 influenced relationships with peers and parents. There were regional differences. Conclusions The current research highlighted the remarkable, healthy, and certainly unexpected, emotional balance of the new generations in the face of a sudden, unpredictable phenomenon capable of jeopardizing life itself. While understanding the gravity of the phenomenon and willingly adapting to all the necessary precautions, the adolescents still seemed to express an excellent ability to manage situations of insecurity and to deal with unfavorable and adverse conditions by adapting to the new routine and finding alternative and innovative means of meeting their social and psychological needs.

Background Asthma control is the goal of the management, but some patients do not achieve adequate control. Adherence to prescriptions is a relevant factor in this issue. As very few studies addressed this problem in adolescents, we investigated this aspect in this setting. Methods This cross-sectional study consecutively enrolled 87 adolescents (60 males, 27 females, median age 14.2 years) with asthma visited at a third-level pediatric clinic. We used two questionnaires: Morisky Medication Adherence Scale (MMAS-8) and TAI. Results As regards MMAS-8, 23 (26.6%) adolescents had low adherence, 34 (39%) medium, and 30 (34.4%) high. Concerning TAI, 34 (39%) had low adherence, 43 (49.5%) medium, and 10 (11.5%) high. After stratification per asthma control grade, adolescents with partly-controlled asthma had the highest scores for medium adherence (p=0.0017 and 0.049, respectively for MMAS-8 and TAI). Conclusions Adolescents with asthma have poor adherence independently to the asthma control grade. This failure implicates that more attention should be paid to this issue in clinical practice.

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Highlights • We surveyed psychological distress by COVID-19 in adults with cystic fibrosis. • Levels of distress were similar in cystic fibrosis and in the general population. • CF lung disease severity and psychological distress were not correlated. • Anxiety and depression symptoms were more frequent in females than in males., Background Hundreds of papers have been published on the COVID-19 pandemic, and several of them on psychological themes connected with it, but very little is so far known on how adult patients with Cystic Fibrosis (pwCFs) are coping with this dramatic event. Methods An online questionnaire was developed according to the Italian validated COVID-19 Peritraumatic Distress Index (CPDI) and addressed to the general population (GP). A similar questionnaire, augmented with CF specific questions, targeted pwCFs. The two web-based surveys were accessible for some weeks during the lockdown mandated by the Italian government. Results The CF questionnaire was completed by 712 adult pwCFs (422 females), matched for sex and age with a 1/5 ratio to GP questionnaire respondents. Mild or medium distress affected 40.2% of pwCFs and 43.9% of GP controls, severe distress 5.3% of pwCFs and 6.2% of GP controls. The level of psychological distress was not correlated with the degree of pulmonary function impairment. When symptoms of anxiety and depression, and physical manifestations were independently analyzed, the control group featured a 55% higher level of mild-moderate anxiety symptoms. Signs of psychological distress, symptoms of anxiety and depression, and physical manifestations were significantly more frequent in female pwCFs compared to males, similarly to GP. Conclusion Adult pwCFs seem to have equal, and in some domains, lower levels of psychological distress than GP controls. This might be sustained by lifelong experiences in coping with the demands of their chronic disease. These results may orient future psychological interventions.

Anxiety and depression may affect asthma control. Previously, it has been reported that the hospital anxiety depression scale (HADS) questionnaire was fruitful in the management of adolescents with asthma. This study compared the scores of two different questionnaires, namely the Childhood Anxiety Sensitivity Index (CASI) and Children's Depression Inventory (CDI), with asthma control level and lung function in asthmatic adolescents, evaluated in a real-life setting.A group of adolescents with asthma was consecutively enrolled. Asthma was diagnosed according to the GINA document, and consistently the symptom control grade was assessed. The adolescents completed the CASI, CDI, and Asthma Control Test (ACT) questionnaires. Visual Analogue Scale (VAS) for asthma symptoms perception and doctor's asthma control evaluation were considered. Lung function and clinical characteristics were also assessed.Totally, 87 asthmatic adolescents (60 males, 27 females, median age 14.2 years) were evaluated. 16.1% of asthmatic adolescents had anxious symptoms detected by CASI, and 11.5% depressive symptoms revealed by CDI. High scores of both CASI and CDI were significantly associated with uncontrolled asthma (p= 0.013 and 0.043, respectively).This study showed that anxiety and depression affected asthma control. Thus, in clinical practice, the psychological assessment could be included in asthmatic adolescents' asthma work-up.

Asthma is a complex and multifactorial disorder. Actually, anxiety may affect asthma, mainly concerning frequent exacerbations, pharmacoeconomic costs, and uncontrolled asthma. On the basis of this background, we tested the hypothesis that anxiety could affect severe asthma outcomes in asthmatic adolescents. Therefore, a longitudinal real-world study included 40 consecutive adolescents (22 males, 18 females, mean age 14.18 ± 1.97 years) with severe asthma and visited for the first time at a third-level pediatric clinic. The current study showed that anxiety is common in adolescents with severe asthma as about 60% of them was anxious. In addition, anxiety was associated with frequent use of bronchodilators on demand. This outcome may conceivably depend on the anxiety trait. Interestingly, depression was present only in anxious adolescents: this outcome underlines the close link between emotional disorders. Therefore, emotional aspect should be considered in the adolescent asthma management in clinical practice. (www.actabiomedica.it)

Emotional problems, such as anxiety and depression, are a relevant co-morbidity in severe asthma. Anxiety and depression may also be common in the parents of asthmatic adolescents. The current study evaluated anxious and depressive symptoms in 40 adolescents suffering from severe asthma, and in their parents, before and after 1 year of treatment, tailored according to validated asthma guidelines. We used the HADS (Hospital Anxiety Depression Scale) questionnaire for the adolescents, and HADS, STAY (State-Trait Anxiety Inventory), and BDI (Beck Depression Inventory) questionnaires for their parents. We also considered the grade of asthma severity before and after 1 year of treatment. The current study demonstrated that anxiety and depression are common in both the adolescents suffering from severe asthma and their parents. Anxious and depressive symptoms were correlated between adolescents and their parents. Asthma treatment improved the asthma severity in almost all adolescents. However, the parental anxiety and depression remained unchanged at the end of the asthma treatment. Thus, a psychological assessment could be included in the adolescent severe asthma work-up, involving both the adolescents and their parents.

Emotional disorders, namely anxiety and depression, frequently affect adolescents with asthma. In addition, their parents also may present emotional problems. The objective of this study was to investigate anxiety and depression in asthmatic adolescents and in their parents in a real-life setting. A series of adolescents with allergic asthma were consecutively enrolled. Asthma was diagnosed according to the GINA document and consistently the symptom control grade was assessed. We used the HADS questionnaire for the adolescents, and HADS, STAY, and BDI questionnaires for their parents. Globally, 121 adolescents (71 males, 50 females, mean age 13.4±0.8 years, age ranging between 12 and 15 years) with allergic asthma and their parents were evaluated. Only 29% of adolescents had controlled asthma. Adolescents with controlled asthma had lower HADS-A and HADS-D scores than other patients, whereas there was no difference among parents. Severe maternal anxiety was more frequent in poorly controlled subjects than in partially controlled ones; absence of maternal anxiety was more common in controlled subjects. The preliminary results of the current study suggest that anxiety and depression are common in adolescents suffering from asthma as well as in their parents, mainly in mothers. Emotional disorders might affect also the asthma control. Thus, in clinical practice, the psychological assessment could be included in the asthma work-up.