title: The impact of illness perceptions and disease severity on quality of life in congenital heart disease.
abstract: BACKGROUND
  Despite an increasing prevalence of adults living with a CHD, little is known about the psychosocial impact of CHD. We sought to investigate the relative impact of disease severity and patients' perceptions about their condition on depression, anxiety, and quality of life over a period of a year.
  
  
  METHODS
  A total of 110 patients aged over 16 years completed an initial questionnaire containing measures for anxiety, depression, quality of life, and illness perceptions when they attended the Adult Congenital Heart Disease Clinic. Cardiologists rated the patients' disease severity and illness course. A year later, patients were invited to complete the same measures. Regression analyses were performed to determine the relative impact of illness perceptions and disease severity on psychological outcomes a year later.
  
  
  RESULTS
  At baseline, 23% of the study population had depressive symptoms and 30% had elevated trait anxiety. After controlling for associations with disease-related variables, illness perceptions explained 28% of the variance in depression, 40% anxiety, and 27% overall quality of life at baseline. Baseline illness perceptions bivariately predicted quality of life, cardiac anxiety, and depression 1 year later, and regression analyses controlling for other factors showed that they were significant predictors of outcomes 1 year later.
  
  
  CONCLUSIONS
  Symptoms of depression and anxiety are common among adults with CHD. Patients' illness perceptions are related to psychological outcomes, especially cross-sectionally. Future research could investigate whether an intervention to discuss patients' perceptions about their CHD can improve mental health and quality of life.
authors.affiliation: 1Department of Psychological Medicine,The University of Auckland,Auckland,New Zealand.
authors.forename: Claire E
authors.initials: CE
authors.lastname: O'Donovan
authors.affiliation: 2Department of Cardiology,Auckland District Health Board,Auckland,New Zealand.
authors.forename: Liz
authors.initials: L
authors.lastname: Painter
authors.affiliation: 2Department of Cardiology,Auckland District Health Board,Auckland,New Zealand.
authors.forename: Boris
authors.initials: B
authors.lastname: Lowe
authors.affiliation: 1Department of Psychological Medicine,The University of Auckland,Auckland,New Zealand.
authors.forename: Hayley
authors.initials: H
authors.lastname: Robinson
authors.affiliation: 1Department of Psychological Medicine,The University of Auckland,Auckland,New Zealand.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Broadbent
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001294:Attitude to Health; D017281:Cost of Illness; D003863:Depression / Q000209:etiology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D055815:Young Adult
keywords: CHD; Illness perceptions; anxiety; depression; quality of life