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Psychological distress in adults with congenital heart disease: focus beyond depression

Published online by Cambridge University Press:  30 January 2019

Lacey P. Gleason ,
Lisa X. Deng ,
Abigail M. Khan ,
David Drajpuch ,
Stephanie Fuller ,
Jonathan Ludmir ,
Christopher E. Mascio ,
Sara L. Partington ,
Lynda Tobin  and
Yuli Y. Kim
...Show all authors
Lacey P. Gleason
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Lisa X. Deng
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Abigail M. Khan
Affiliation:
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
David Drajpuch
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Stephanie Fuller
Affiliation:
Division of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Jonathan Ludmir
Affiliation:
Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA, USA
Christopher E. Mascio
Affiliation:
Division of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Sara L. Partington
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Lynda Tobin
Affiliation:
Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Yuli Y. Kim
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Adrienne H. Kovacs*
Affiliation:
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
*
Author for correspondence: Adrienne H. Kovacs, PhD, Division of Cardiology, Department of Medicine, Oregon Health & Science University, 3181 Sam Jackson Park Rd, UHN-62, Portland, OR, 97239, USA. Tel: 503-494-7400; E-mail: kovacs@ohsu.edu
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Abstract

Background

Adults with congenital heart disease face psychological challenges although an understanding of depression vs. anxiety symptoms is unclear. We analyzed the prevalence of elevated symptoms of anxiety and depression and explored associations with demographic and medical factors as well as quality of life.

Methods

Adults with congenital heart disease enrolled from an outpatient clinic completed the Hospital Anxiety and Depression Scale and two measures of quality of life: the Linear Analogue Scale and the Satisfaction with Life Scale. Medical data were obtained by chart review.

Results

Of 130 patients (median age = 32 years; 55% female), 55 (42%) had elevated anxiety symptoms and 16 (12%) had elevated depression symptoms on subscales of the Hospital Anxiety and Depression Scale. Most patients with elevated depression symptoms also had elevated anxiety symptoms (15/16; 94%). Of 56 patients with at least one elevated subscale, 37 (66%) were not receiving mental health treatment. Compared to patients with 0 or 1 elevated subscales, patients with elevations in both (n=15) were less likely to be studying or working (47% vs. 81%; p=0.016) and reported lower scores on the Linear Analogue Scale (60 vs. 81, p<0.001) and the Satisfaction with Life Scale (14 vs. 28, p<0.001).

Conclusions

Among adults with congenital heart disease, elevated anxiety symptoms are common and typically accompany elevated depressive symptoms. The combination is associated with unemployment and lower quality of life. Improved strategies to provide psychosocial care and support appropriate engagement in employment are required.

Keywords

Adult Congenital Heart DiseaseAnxietyDepressionQuality of Life
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 2 , February 2019 , pp. 185 - 189
Copyright
© Cambridge University Press 2019 

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Footnotes

Cite this article: Gleason LP, Deng LX, Khan AM, Drajpuch D, Fuller S, Ludmir J, Mascio CE, Partington SL, Tobin L, Kim YY, Kovacs AH. (2019) Psychological Distress in Adults with Congenital Heart Disease: Focus beyond Depression. Cardiology in the Young page 185 of 189. doi: 10.1017/S1047951118002068

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