title: Family-based associations in measures of psychological distress and quality of life in a cardiac screening clinic for inheritable cardiac diseases: a cross-sectional study.
abstract: BACKGROUND
  Family-based cardiac screening programmes for persons at risk for genetic cardiac diseases are now recommended. However, the psychological wellbeing and health related quality of life (QoL) of such screened patients is poorly understood, especially in younger patients. We sought to examine wellbeing and QoL in a representative group of adults aged 16 and over in a dedicated family cardiac screening clinic.
  
  
  METHODS
  Prospective survey of consecutive consenting patients attending a cardiac screening clinic, over a 12 month period. Data were collected using two health measurement tools: the Short Form 12 (version 2) and the Hospital Anxiety and Depression Scale (HADS), along with baseline demographic and screening visit-related data. The HADS and SF-12v.2 outcomes were compared by age group. Associations with a higher HADS score were examined using logistic regression, with multi-level modelling used to account for the family-based structure of the data.
  
  
  RESULTS
  There was a study response rate of 86.6%, with n=334 patients providing valid HADS data (valid response rate 79.5%), and data on n=316 retained for analysis. One-fifth of patients were aged under 25 (n=61). Younger patients were less likely than older to describe significant depression on their HADS scale (p<0.0001), although there were overall no difference between the prevalence of a significant HADS score between the younger and older age groups (18.0% vs 20.0%, p=0.73). Significant positive associates of a higher HADS score were having lower educational attainment, being single or separated, and being closely related to the family proband. Between-family variance in anxiety and depression scores was greater than within-family variance.
  
  
  CONCLUSIONS
  High levels of anxiety were seen amongst patients attending a family-based cardiac screening clinic.Younger patients also had high rates of clinically significant anxiety. Higher levels of anxiety and depression tends to run in families, and this has implications for family screening and intervention programmes.
authors.affiliation: The Heart House, Mater Misericordiae University Hospital, Dublin 7, Ireland. Catherine.mcgorrian@ucd.ie
authors.forename: Catherine
authors.initials: C
authors.lastname: McGorrian
authors.forename: Charlene
authors.initials: C
authors.lastname: McShane
authors.forename: Colin
authors.initials: C
authors.lastname: McQuade
authors.forename: Ted
authors.initials: T
authors.lastname: Keelan
authors.forename: Jim O
authors.initials: JO
authors.lastname: Neill
authors.forename: Joseph
authors.initials: J
authors.lastname: Galvin
authors.forename: Kevin
authors.initials: K
authors.lastname: Malone
authors.forename: Niall G
authors.initials: NG
authors.lastname: Mahon
authors.forename: Mary
authors.initials: M
authors.lastname: Codd
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000554:Ambulatory Care Facilities; D001007:Anxiety / Q000523:psychology*; D003430:Cross-Sectional Studies; D003625:Data Collection; D003710:Demography; D003863:Depression / Q000523:psychology*; D005192:Family Health; D005260:Female; D005820:Genetic Testing; D006331:Heart Diseases / Q000235:genetics* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012017:Referral and Consultation; D012044:Regression Analysis; D055815:Young Adult