title: Psychiatric disorders and function in adolescents with d-transposition of the great arteries.
abstract: OBJECTIVE
  To compare adolescents with d-transposition of the great arteries (d-TGA) with healthy adolescents with respect to prevalence of psychiatric disorders and global psychosocial functioning.
  
  
  METHODS
  Subjects, consisting of 139 adolescents with d-TGA (16.1 ± 0.5 years) and 61 healthy adolescents (15.3 ± 1.1 years) without known risk factors for brain disorders, underwent a battery of assessments, including semistructured psychiatric interviews; self-report measures of depressive, anxiety, and disruptive behavior symptoms; and brain magnetic resonance imaging. Previous cognitive functioning and parental stress assessments at age 8 as well as parental post-traumatic stress at age 16 years were explored as potential risk factors predictive of overall psychiatric functioning.
  
  
  RESULTS
  Compared with healthy adolescents, adolescents with d-TGA had higher lifetime prevalence of structured interview-derived attention-deficit/hyperactivity disorder (19% vs 7%, P = .03), along with reduced global psychosocial functioning (80.6 ± 11.2 vs 87.2 ± 7.1, P < .001) as well as significant increases in self-reported depressive (P = .01), anxiety (P = .02), and disruptive behavior symptoms (parent P < .001 and adolescent P = .03). Nevertheless, these youth scored in the nonclinical range on all self-report measures. Level of global psychosocial functioning was positively related to cognitive functioning (P < .001) and negatively related to parental stress (P = .008).
  
  
  CONCLUSIONS
  Although adolescents with d-TGA demonstrate significant resilience to known neuropsychological and academic deficits, they show increased rates of attention-deficit/hyperactivity disorder and reduced psychosocial functioning. Impaired cognitive functioning and parental stress at younger age emerged as significant risk factors for psychiatric impairment.
authors: Department of Psychiatry, Boston Children's Hospital, Boston, MA; Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
authors: David R
authors: DR
authors: DeMaso
authors: Department of Psychiatry, Boston Children's Hospital, Boston, MA.
authors: Madelyn
authors: M
authors: Labella
authors: Department of Psychiatry, Boston Children's Hospital, Boston, MA.
authors: George Alexander
authors: GA
authors: Taylor
authors: Department of Psychiatry, Boston Children's Hospital, Boston, MA.
authors: Peter W
authors: PW
authors: Forbes
authors: Department of Cardiology, Boston Children's Hospital, Boston, MA.
authors: Christian
authors: C
authors: Stopp
authors: Department of Psychiatry, Boston Children's Hospital, Boston, MA; Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Environment Health, Harvard School of Public Health, Boston, MA; Department of Neurology, Harvard Medical School, Boston, MA.
authors: David C
authors: DC
authors: Bellinger
authors: Department of Psychiatry, Boston Children's Hospital, Boston, MA; Department of Neurology, Harvard Medical School, Boston, MA; Department of Neurology, Boston Children's Hospital, Boston, MA.
authors: Michael J
authors: MJ
authors: Rivkin
authors: Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA.
authors: David
authors: D
authors: Wypij
authors: Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
authors: Jane W
authors: JW
authors: Newburger
mesh_terms: D000293:Adolescent; D001519:Behavior; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D003071:Cognition; D003072:Cognition Disorders; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications; D013315:Stress, Psychological; D014188:Transposition of Great Vessels / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*