What is the clinical evidence from this study?

Study design: Observational. Population: Small, unrepaired atrial septal defects (ASD) (n=1260). Intervention: Small, unrepaired atrial septal defect vs. Age- and gender-matched reference group. Primary outcome: Symptoms of depression and anxiety (SCL-8 score) (p=<0.001).

May 28, 2019Congenital Heart Disease

Small atrial septal defects are associated with psychiatric diagnoses, emotional distress, and lower educational levels

Q: What are the key findings of this study?

Adult patients with a small, unrepaired atrial septal defect had significantly higher self-reported scores for depression and anxiety compared to a matched reference group (0.57 vs 0.39, p<0.001).

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Key result

Adult patients with a small, unrepaired atrial septal defect had significantly higher self-reported scores for depression and anxiety compared to a matched reference group (0.57 vs 0.39, p<0.001).

Why the study?

The psychiatric burden, emotional distress, and educational status in adult patients living with small, unrepaired atrial septal defects had not been assessed.

Do adult patients with small, unrepaired ASD have higher rates of psychiatric diagnoses, emotional distress, and lower educational levels compared to a reference group?

Population

723 Danish adult patients with small, unrepaired ASD diagnosed between 1953 and 2011

Comparison

Adults with small, unrepaired ASD vs age- and gender-matched reference individuals

Design

Descriptive study using registries and questionnaires

Authors

SUSebastian UdholmAarhus University Hospital CNCamilla NyboeAarhus University TDThomas Meinertz DantoftFrederiksberg Hospital

Discussion

Member takes

Implication

Small unrepaired ASD was associated with higher anxiety, depression, and lower education; hypothesis-generating for mental health screening in adult CHD.

Study Design

Type

Observational (n=1,260)

Structured PICO

Do adult patients with small, unrepaired ASD have higher rates of psychiatric diagnoses, emotional distress, and lower educational levels compared to a reference group?

Population

1,260 adults (140 with small, unrepaired atrial septal defects and 1,120 matched reference individuals) aged 18 to 65 years, assessed for psychiatric burden and educational attainment.

Exposure

Small, unrepaired atrial septal defect (observational exposure)

Comparator

Age- and gender-matched individuals from the Danish study of Functional Disorders (DanFunD) reference group (n=1120)

Outcome

Number of register-based psychiatric diagnoses, symptoms of anxiety, depression, somatization, health anxiety, illness perception, and levels of educational attainmentpatient reported

Main Result

Absolute Event Rate: 0.57% vs 0.39%

p-value: p=<0.001

Adults with small, unrepaired ASD experience significantly higher levels of anxiety, depression, and somatization, as well as lower educational attainment, compared to the general population, supporting the need for lifelong specialized follow-up.

Limitations

Exclusion of patients with severe mental and psychiatric issues may have led to selection bias, representing the healthiest patients.
Relatively low recruitment rate of patients.
Use of self-reported measures rather than semi-structured clinical interviews for diagnosing psychiatric disease.
Lack of detailed data on defect characteristics and shunt dimensions at the time of diagnosis.
Exclusion of patients with severe mental and psychiatric issues, likely representing the healthiest patients
Reference group (DanFunD) might not be generalizable to the entire Danish population
Relatively low recruitment rate reducing generalizability
Lack of previous data on defect characteristics and shunt dimensions at time of diagnosis
Use of self-reported measures rather than semi-structured clinical interviews for diagnosing psychiatric disease

Cite This Study

Udholm et al. (2019) conducted an observational in Small, unrepaired atrial septal defects (ASD) (n=1,260). Small, unrepaired atrial septal defect vs. Age- and gender-matched reference group was evaluated on Symptoms of depression and anxiety (SCL-8 score) (p=<0.001). Adult patients with a small, unrepaired atrial septal defect had significantly higher self-reported scores for depression and anxiety compared to a matched reference group (0.57 vs 0.39, p<0.001).

synapsesocial.com/papers/6a98c9f408ab6325d2e10b44 https://doi.org/10.1111/chd.12808

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Implication

Small unrepaired ASD was associated with higher anxiety, depression, and lower education; hypothesis-generating for mental health screening in adult CHD.

Small atrial septal defects are associated with psychiatric diagnoses, emotional distress, and lower educational levels

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Small atrial septal defects are associated with psychiatric diagnoses, emotional distress, and lower educational levels

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider