Psychiatric evaluation of children and adolescents with left ventricular assist devices.
OBJECTIVE
To evaluate the psychiatric symptoms of children equipped with a ventricular assist device (VAD) and follow them up for 6 months. With the shortage of donor hearts available for the treatment of end-stage heart failure, VADs have been used to provide temporary treatment until a heart becomes available. VADs provide external sources of power for mechanical circulatory support and are capable of sustaining life over weeks and months. This study provides preliminary details about the psychiatric symptoms and disorders of the first eight children equipped with a VAD in Turkey.


METHODS
Eight pediatric patients who recently underwent VAD implantation, aged 1 to 16 years, were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia, Child Behavior Checklist, Children's Depression Inventory, Beck Depression Inventory, and State-Trait Anxiety Inventory for Children and followed up for 6 months.


RESULTS
In the first evaluation, five participants had a psychiatric disorder diagnosis. Two patients had adjustment disorder with depressive and anxiety symptoms; one had anxiety disorder, not otherwise specified; and two had major depressive disorder. The anxiety and depressive symptom levels in questionnaires were consistent with psychiatric diagnoses. Two patients had heart transplantation during the follow-up period.


CONCLUSIONS
To determine and treat psychiatric symptoms and disorders at an earlier stage, it is important for children and adolescents with a VAD and those who have undergone heart transplantation to be evaluated by a multidisciplinary consultation liaison team including psychiatrists, psychologists, consultant nurses, and counselors.
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, Bornova Izmir, Turkey. drbbeker@yahoo.com
Burcu
B
Ozbaran
Sezen
S
Kose
Tahir
T
Yagdi
Cagatay
C
Engin
Serpil
S
Erermis
Taciser
T
Uysal
Fatih
F
Ayik
Sultan
S
Karakula
Zulal
Z
Ulger
Yuksel
Y
Atay
Mustafa
M
Ozbaran
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000523:psychology / Q000601:surgery*; D016027:Heart Transplantation / Q000523:psychology; D006353:Heart-Assist Devices / Q000523:psychology*; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis*; D010348:Patient Care Team; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014421:Turkey