Among 3,815 adults with congenital heart disease, 30.1% had elevated depression and/or anxiety symptoms, which were associated with decreased quality of life and health status (P<0.001).
Cross-Sectional (n=3,815)
Yes
p-value: p=<0.001
BACKGROUND A comprehensive understanding of adult congenital heart disease outcomes must include psychological functioning. Our multisite study offered the opportunity to explore depression and anxiety symptoms within a global sample. OBJECTIVES In this substudy of the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults With Congenital Heart Disease-International Study), the authors we investigated the prevalence of elevated depression and anxiety symptoms, explored associated sociodemographic and medical factors, and examined how quality of life (QOL) and health status (HS) differ according to the degree of psychological symptoms. METHODS Participants completed the Hospital Anxiety and Depression Scale, which includes subscales for symptoms of anxiety (HADS-A) and depression (HADS-D). Subscale scores of 8 or higher indicate clinically elevated symptoms and can be further categorized as mild, moderate, or severe. Participants also completed analogue scales on a scale of 0 to 100 for QOL and HS. Analysis of variance was performed to investigate whether QOL and HS differed by symptom category. RESULTS Of 3,815 participants from 15 countries (age 34.8 ± 12.9 years; 52.7% female), 1,148 (30.1%) had elevated symptoms in one or both subscales: elevated HADS-A only (18.3%), elevated HADS-D only (2.9%), or elevations on both subscales (8.9%). Percentages varied among countries. Both QOL and HS decreased in accordance with increasing HADS-A and HADS-D symptom categories (P < 0.001). CONCLUSIONS In this global sample of adults with congenital heart disease, almost one-third reported elevated symptoms of depression and/or anxiety, which in turn were associated with lower QOL and HS. We strongly advocate for the implementation of strategies to recognize and manage psychological distress in clinical settings. (Patient-Reported Outcomes in Adults With Congenital Heart Disease APPROACH-IS; NCT02150603).
“We have known about psychological challenges faced by people with congenital heart disease for decades. We as a writing group agreed that it is time to move from awareness to implementation of strategies to manage psychological distress and foster resilience in clinical care settings, ideally through the integration of a mental health professionals.”
Kovacs et al. (Mon,) conducted a cross-sectional in Congenital heart disease (n=3,815). Elevated depression and anxiety symptoms vs. Lower symptom categories was evaluated on Prevalence of elevated depression and anxiety symptoms and their association with quality of life and health status (p=<0.001). Among 3,815 adults with congenital heart disease, 30.1% had elevated depression and/or anxiety symptoms, which were associated with decreased quality of life and health status (P<0.001).
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