title: Associations among Depression Symptoms with Alcohol and Smoking Tobacco Use in Adult Patients with Congenital Heart Disease.
abstract: BACKGROUND
  Adult congenital heart disease (ACHD) patients have high rates of untreated depression and anxiety disorders. We evaluated associations among self-reported depression symptoms and alcohol/smoking tobacco use.
  
  
  METHODS
  From 2009 to 2013, 202 ACHD patients (45% male) completed questionnaires on depressive symptoms, anxiety symptoms, and substance use as part of routine clinical care. Data were collected by retrospective chart review.
  
  
  RESULTS
  Mean age was 31 ± 10 years, 21% reported often feeling depressed and 33% reported feeling nervous or anxious. Sixty-one percent of patients reported some alcohol intake; 25% reported current or previous smoking tobacco use. Patients with depressive symptoms were 3× as likely to report drinking alcohol (OR 2.89; 95% CI 1.29-6.5) and 5× more likely to report smoking tobacco use (OR 5.17; 95% CI 1.49-17.87). Fourteen percent of patients were prescribed antidepressant/antianxiety medications; 43% of patients on medication reported depressive symptoms. In patients reporting symptoms, those who consumed alcohol were less likely to be on antidepressant/antianxiety medications (21%) than those who did not consume alcohol (56%).
  
  
  CONCLUSIONS
  Self-reported depressive symptoms are associated with increased alcohol and smoking tobacco use by ACHD patients. Alcohol use may be a means of self-medicating for untreated depression, but further investigation is needed. Risk factors, including depressive symptoms and substance use, should be routinely assessed and addressed in ACHD patients.
authors.affiliation: Children's National Heart Institute, Children's National Health System, George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Munziba
authors.initials: M
authors.lastname: Khan
authors.affiliation: Center for Translational Science, Children's National Health System, George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Monaghan
authors.affiliation: Children's National Heart Institute, Children's National Health System, George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Klein
authors.affiliation: Children's National Heart Institute, Children's National Health System, George Washington University School of Medicine, Washington, DC, USA.|Division of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: George
authors.initials: G
authors.lastname: Ruiz
authors.affiliation: Children's National Heart Institute, Children's National Health System, George Washington University School of Medicine, Washington, DC, USA.|Division of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: Anitha S
authors.initials: AS
authors.lastname: John
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000523:psychology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D004219:District of Columbia; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adult Congenital Heart Disease; Alcohol; Depression