{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:21:16Z","timestamp":1790144476038,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Females with cystic fibrosis (CF) experience worse health outcomes than males. Given this sex disparity, we examined the impact of gender on mental health\u2010related quality of life (QoL) and mental well\u2010being among people with CF (PwCF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used Wellness in the Modulator Era (Well\u2010ME) survey data from 587 adults and 275 parents\/caregivers providing proxy report for children to identify gender differences in mental health\u2010related QoL on PROMIS measures and reported changes in mental well\u2010being 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\u2013Hochberg method. Thematic and content analyses identified mental well\u2010being themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were no gender differences in mental health QoL, but women more often reported worsening mental well\u2010being than men (33% vs. 18%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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\u2010being, to inform strategies to mitigate risks following modulator initiation, and to improve mental health of PwCF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71394","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T11:21:21Z","timestamp":1763551281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gender Differences in Mental Well\u2010Being Among Children and Adults With Cystic Fibrosis in the Modulator Era"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0924-4031","authenticated-orcid":false,"given":"Anna M.","family":"Georgiopoulos","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2961-5661","authenticated-orcid":false,"given":"Aricca D.","family":"Van Citters","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Occupational and Sleep Medicine, Indiana University School of Medicine Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8819-9291","authenticated-orcid":false,"given":"Elizabeth","family":"Yu","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Foundation Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily A.","family":"Zagnit","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Foundation Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enid","family":"Aliaj","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Foundation Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2932-4768","authenticated-orcid":false,"given":"Joel R.","family":"King","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy &amp; Clinical Practice, Geisel School of Medicine at Dartmouth Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3916-8260","authenticated-orcid":false,"given":"Traci M.","family":"Kazmerski","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2024.06.010"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2024.11.006"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2014.4985"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202008-1064OC"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2022.08.018"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2023.05.009"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2020.07.020"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000102"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000531588"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-205983"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.10.043"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-009-9496-9"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-013-0581-8"},{"key":"e_1_2_10_16_1","unstructured":"Health Measures PROMIS Northwestern University accessed August 14 2024 https:\/\/www.healthmeasures.net\/score-and-interpret\/interpret-scores\/promis."},{"issue":"7","key":"e_1_2_10_17_1","first-page":"28","article-title":"The Clinical Global Impressions Scale: Applying a Research Tool in Clinical Practice","volume":"4","author":"Busner J.","year":"2007","journal-title":"Psychiatry (Edgmont (Pa.: Township))"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"e_1_2_10_19_1","unstructured":"IBM Corp. 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