Risk for first onset depression in adults with congenital heart disease

Background: The long-term risk for depression among adults with congenital heart disease (ACHD) is unclear. Therefore, we assessed the risk for first onset of serious depression in patients with ACHD compared with a sex- and age-matched control population without a congenital heart disease (CHD) diagnosis. Methods: We extracted all patients with CHD born from 1970 to 1999 who survived until age 18 years from the Swedish National Patient Register. For each case, 10 random controls without CHD were selected from the general population and matched by birth year and sex. Participants were followed-up until the first diagnosis of new onset serious depression requiring hospital or specialist outpatient care. Results: This study included 22,912 patients with ACHD and 224,259 controls. The mean age at depression onset was 30.1 years in the ACHD group and 30.3 years in controls. The overall associated risk for serious depression was higher among patients with ACHD compared with controls, with an adjusted hazard ratio (aHR) of 1.32 (95% confidence interval [CI]: 1.20-1.44). Patients in the complex lesion group had a 54% higher risk for depression (aHR 1.54, 95% CI: 1.10-2.18) compared with the control group. The corresponding result for the non-complex lesion group was aHR 1.30 (95% CI: 1.18-1.43). Conclusion: The long-term risk for serious depression was higher among young and middle-aged patients with ACHD compared with matched controls. The risk was particularly elevated among patients with complex lesions. Patients with ACHD need support through strategies to prevent depression.