Anxiety and Depression in Adults With Congenital Heart Disease
IntroductionAnxiety and depression can worsen outcome in patients with heart disease. We elucidate the prevalence of anxiety and depression in a cohort of adults with congenital heart disease (ACHD).Materials and MethodsProspective screening for anxiety or depression was performed in 204 consecutive...
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.906385/full |
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| author | Corinna Lebherz Michael Frick Jens Panse Jens Panse Philipp Wienstroer Katrin Brehmer Katrin Brehmer Gunter Kerst Nikolaus Marx Klaus Mathiak Hedwig Hövels-Gürich |
| author_facet | Corinna Lebherz Michael Frick Jens Panse Jens Panse Philipp Wienstroer Katrin Brehmer Katrin Brehmer Gunter Kerst Nikolaus Marx Klaus Mathiak Hedwig Hövels-Gürich |
| author_sort | Corinna Lebherz |
| collection | DOAJ |
| description | IntroductionAnxiety and depression can worsen outcome in patients with heart disease. We elucidate the prevalence of anxiety and depression in a cohort of adults with congenital heart disease (ACHD).Materials and MethodsProspective screening for anxiety or depression was performed in 204 consecutive patients of the outpatient clinic of our tertiary care center using the Hospital Anxiety and Depression Scale (HADS) questionnaire and the distress thermometer (DT) as a potential ultra-short screening test. Functional data were assessed at liberty of the responsible physician. HADS scores ≥ 8 were considered doubtful and scores ≥ 11 as confirmed cases of anxiety or depression, respectively. HADS results were compared with a historical group of 100 patients with non-Hodgkin Lymphoma (NHL) as well as German reference values from the literature.ResultsPatients from the ACHD cohort were 28 ± 10 years old (mean ± SD, 54% male), 34% had a simple, 51% a moderate, including 52 patients with transposition of the great arteries after arterial switch operation, and 15% a heart defect of severe complexity. Prevalence of depression in ACHD was comparable to the German normal population (5.9% ACHD vs. 5.4% control). In contrast, prevalence of anxiety was higher than expected from reference values (12.7% ACHD vs. 5.6% control). There was a positive association between psychological distress and NYHA class [anxiety: OR 2.67 (95% CI, 1.50–4.76) p = 0.001; depression: OR 2.93 (95% CI, 1.60–5.35) p = 0.0005], but not with age, gender, or heart defect severity. Percentages of patients with ACHD with anxiety were significantly higher than in a cohort of patients with indolent non-Hodgkin lymphoma (NHL) but comparable to those with aggressive NHL (HADS-A ≥ 11: ACHD 12.7%, indolent NHL 2.2%, aggressive NHL 13.2%; p = 0.037 ACHD vs. indolent NHL; p = 0.929 ACHD vs. aggressive NHL). The distress thermometer screening test had only a fair discriminatory ability (AUC 0.708; p = 0.002) and is therefore of limited usability.ConclusionAdults with congenital heart disease exhibit an increased risk for anxiety disorders independently of the severity of the underlying heart defect. Anxiety prevalence was comparable to a historical cohort of patients with aggressive NHL underlining the importance of a routine screening for psychosocial distress in adults with congenital heart disease. |
| first_indexed | 2024-12-12T06:15:38Z |
| format | Article |
| id | doaj.art-548c6af6b85347a988d0791de1da07e6 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-12T06:15:38Z |
| publishDate | 2022-06-01 |
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| series | Frontiers in Pediatrics |
| spelling | doaj.art-548c6af6b85347a988d0791de1da07e62022-12-22T00:35:02ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-06-011010.3389/fped.2022.906385906385Anxiety and Depression in Adults With Congenital Heart DiseaseCorinna Lebherz0Michael Frick1Jens Panse2Jens Panse3Philipp Wienstroer4Katrin Brehmer5Katrin Brehmer6Gunter Kerst7Nikolaus Marx8Klaus Mathiak9Hedwig Hövels-Gürich10Department of Cardiology, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Cardiology, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, GermanyCenter for Integrated Oncology Aachen Bonn Cologne Düesseldorf (CIO-ABCD), Aachen, GermanyDepartment of Cardiology, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Cardiology, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Cardiology, DIAK Hospital, Schwäbisch Hall, GermanyDepartment of Pediatric Cardiology, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Cardiology, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, GermanyDepartment of Pediatric Cardiology, University Hospital RWTH Aachen, Aachen, GermanyIntroductionAnxiety and depression can worsen outcome in patients with heart disease. We elucidate the prevalence of anxiety and depression in a cohort of adults with congenital heart disease (ACHD).Materials and MethodsProspective screening for anxiety or depression was performed in 204 consecutive patients of the outpatient clinic of our tertiary care center using the Hospital Anxiety and Depression Scale (HADS) questionnaire and the distress thermometer (DT) as a potential ultra-short screening test. Functional data were assessed at liberty of the responsible physician. HADS scores ≥ 8 were considered doubtful and scores ≥ 11 as confirmed cases of anxiety or depression, respectively. HADS results were compared with a historical group of 100 patients with non-Hodgkin Lymphoma (NHL) as well as German reference values from the literature.ResultsPatients from the ACHD cohort were 28 ± 10 years old (mean ± SD, 54% male), 34% had a simple, 51% a moderate, including 52 patients with transposition of the great arteries after arterial switch operation, and 15% a heart defect of severe complexity. Prevalence of depression in ACHD was comparable to the German normal population (5.9% ACHD vs. 5.4% control). In contrast, prevalence of anxiety was higher than expected from reference values (12.7% ACHD vs. 5.6% control). There was a positive association between psychological distress and NYHA class [anxiety: OR 2.67 (95% CI, 1.50–4.76) p = 0.001; depression: OR 2.93 (95% CI, 1.60–5.35) p = 0.0005], but not with age, gender, or heart defect severity. Percentages of patients with ACHD with anxiety were significantly higher than in a cohort of patients with indolent non-Hodgkin lymphoma (NHL) but comparable to those with aggressive NHL (HADS-A ≥ 11: ACHD 12.7%, indolent NHL 2.2%, aggressive NHL 13.2%; p = 0.037 ACHD vs. indolent NHL; p = 0.929 ACHD vs. aggressive NHL). The distress thermometer screening test had only a fair discriminatory ability (AUC 0.708; p = 0.002) and is therefore of limited usability.ConclusionAdults with congenital heart disease exhibit an increased risk for anxiety disorders independently of the severity of the underlying heart defect. Anxiety prevalence was comparable to a historical cohort of patients with aggressive NHL underlining the importance of a routine screening for psychosocial distress in adults with congenital heart disease.https://www.frontiersin.org/articles/10.3389/fped.2022.906385/fullanxietydepressionACHD adult congenital heart diseaselocus of controlHospital Anxiety and Depression Scale (HADS) |
| spellingShingle | Corinna Lebherz Michael Frick Jens Panse Jens Panse Philipp Wienstroer Katrin Brehmer Katrin Brehmer Gunter Kerst Nikolaus Marx Klaus Mathiak Hedwig Hövels-Gürich Anxiety and Depression in Adults With Congenital Heart Disease Frontiers in Pediatrics anxiety depression ACHD adult congenital heart disease locus of control Hospital Anxiety and Depression Scale (HADS) |
| title | Anxiety and Depression in Adults With Congenital Heart Disease |
| title_full | Anxiety and Depression in Adults With Congenital Heart Disease |
| title_fullStr | Anxiety and Depression in Adults With Congenital Heart Disease |
| title_full_unstemmed | Anxiety and Depression in Adults With Congenital Heart Disease |
| title_short | Anxiety and Depression in Adults With Congenital Heart Disease |
| title_sort | anxiety and depression in adults with congenital heart disease |
| topic | anxiety depression ACHD adult congenital heart disease locus of control Hospital Anxiety and Depression Scale (HADS) |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.906385/full |
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