title: Shock-related anxiety and sexual function in adults with congenital heart disease and implantable cardioverter-defibrillators.
abstract: BACKGROUND
  An increasing number of adults with congenital heart disease (CHD) require implantable cardioverter-defibrillators (ICDs), yet little is known about their impact on psychological well-being and sexual function.
  
  
  OBJECTIVE
  To assess shock-related anxiety in adults with CHD and its association with depression and sexual function.
  
  
  METHODS
  A prospective, multicenter, cross-sectional study was conducted on adult patients with CHD with (ICD(+)) and without (ICD(-)) ICDs. The Florida Shock Anxiety Scale was administered to patients with ICD(+) and the Beck Depression Inventory-II to all patients. Men completed the Sexual Health Inventory for Men, and women completed the Female Sexual Function Index.
  
  
  RESULTS
  A total of 180 adults with CHD (ICD(+): n = 70; ICD(-): n = 110; median age 32 years [interquartile range 27-40 years]; 44% women) were enrolled. The complexity of CHD was classified as mild in 32 (18%), moderate in 93 (52%), and severe in 54 (30%) subjects. In ICD recipients, a high level of shock-related anxiety was identified (Florida Shock Anxiety Scale score 16; interquartile range 12-23.5), which was slightly higher than the median score for ICD recipients in the general population (P = .057). A higher level of shock-related anxiety was associated with poorer sexual function scores in both men (Spearman's ρ =-.480; P<.001) and women (Spearman's ρ =-.512; P<.01). It was also associated with self-reported depressive symptomatology (Spearman's ρ = .536; P< .001).
  
  
  CONCLUSIONS
  Adults with CHD and ICDs demonstrate a high level of shock-related anxiety, which is associated with lower sexual functioning scores in men and women. These results underscore the need for increased clinical attention related to ICD-related shock anxiety and impaired sexual function in this population.
authors: Adult Congenital Heart Disease Center, Heart Institute, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15224, USA. stephen.cook@chp.edu
authors: Stephen C
authors: SC
authors: Cook
authors: Anne Marie
authors: AM
authors: Valente
authors: Timothy M
authors: TM
authors: Maul
authors: Mary Amanda
authors: MA
authors: Dew
authors: Jenne
authors: J
authors: Hickey
authors: Psyd
authors: P
authors: Jennifer Burger
authors: Amy
authors: A
authors: Harmon
authors: Mathieu
authors: M
authors: Clair
authors: Gregory
authors: G
authors: Webster
authors: Frank
authors: F
authors: Cecchin
authors: Paul
authors: P
authors: Khairy
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D004554:Electric Countershock / Q000523:psychology*; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D013315:Stress, Psychological