A cohort study on psychosocial adjustment and psychopathology in adolescents and young adults with congenital heart disease.
OBJECTIVE
Our purpose was to study psychosocial adjustment and psychiatric morbidity of adolescents and young adults with congenital heart disease (CHD).


METHODS
All assessment measures were obtained on a single occasion. Clinical data was obtained through the patient's clinical records.


METHODS
A teaching and tertiary care facility in Porto, Portugal.


METHODS
We evaluated 110 CHD patients (62 male) aged from 12 to 26 years (mean=18.00±3.617), 58 cyanotic. All assessment measures were obtained on a single occasion in a tertiary hospital. Demographic information and clinical history were collected.


METHODS
Questionnaires regarded topics such as social support, family educational style, self-image and physical limitations, a standardised psychiatric interview Schedule for Affective Disorders and Schizophrenia-Lifetime version (SADS-L), and a self-report questionnaire on psychosocial adjustment, youth self-report or adult self-report. One of the relatives completed an observational version of the same questionnaire (child behaviour checklist (CBCL) or ABCL (adult behaviour checklist)).


RESULTS
We found a 21.8% lifetime prevalence of psychopathology, 31.3%, in females, 14.5% in males, showing a somewhat increased proneness in CHD patients. Females also showed worse psychosocial adjustment, with more somatic complaints (u=260 000; p=0.011), anxiety/depression (u=984 000; p=0.002), aggressive behaviour (u=920 500; p=0.001), attention problems (u=1123 500; p=0.027), thought problems (u=1069 500; p=0.010), internalisation (u=869 000; p=0.0) and externalisation (u=1163 000; p=0.05). Patients with severe CHD (u=939 000; p=0.03) and surgical repair (u=719 000; p=0.037) showed worse psychosocial adjustment. Those with poor social support showed more withdrawal (u=557 500; p=0.0) and social problems (u=748 500; p=0.023), and patients with unsatisfactory school performance revealed more anxiety/depression (u=916 000; p=0.02) and attention problems (u=861 500; p=0.007).


CONCLUSIONS
CHD males with good social support and good academic performance have a better psychosocial adjustment.
Department of Psychology,  Instituto Superior de Ciências da Saúde do Norte (CESPU), Gandra,  Portugal.
Isabela Ribeiro
IR
Freitas
Marta
M
Castro
Sofia Lourenço
SL
Sarmento
Cláudia
C
Moura
Victor
V
Viana
José Carlos
JC
Areias
Maria Emília Guimarães
ME
Areias