title: Correlates of posttraumatic stress disorder in adults with congenital heart disease.
abstract: OBJECTIVE
  The aims of this study were to compare the level of posttraumatic stress disorder between adults with and without congenital heart disease, and to examine the correlates of posttraumatic stress disorder (e.g., sociodemographics).
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Two university-affiliated heart hospitals in Tehran, Iran.
  
  
  METHODS
  A sample of 347 adults with congenital heart disease aged 18-64 years (52% women), and 353 adults without congenital heart disease matched by sex and age (±2 years) was recruited.
  
  
  METHODS
  The PTSD Scale: Self-report version was used to assess the diagnosis and severity of posttraumatic stress disorder. Hierarchical multivariate logistic regression analyses were performed to explore correlates of likely posttraumatic stress disorder diagnosis among each group of participants.
  
  
  RESULTS
  The posttraumatic stress disorder in the patients was comparable to those of the control group, except for increased arousal (P = .027) which was scored higher among the patients. Over 52% of adults with congenital heart disease met the criteria for a likely posttraumatic stress disorder diagnosis compared with 48% of adults without congenital heart disease. The regression analyses among patients revealed that elevated depressive symptoms (OR = 1.27) and a positive history of cardiac surgery (OR = 2.02) were significantly associated with posttraumatic stress disorder. The model could explain 29% of the variance in posttraumatic stress disorder.
  
  
  CONCLUSIONS
  The high and comparable prevalence of posttraumatic stress disorder among patients and nonpatients highlight the significance of the context in which adults with congenital heart disease may face other/additional stressors than disease-related ones, an issue that clinicians need also take into account. Furthermore, the association of posttraumatic stress disorder with elevated depressive symptoms warrant a comprehensive psychological assessment and management of adults with congenital heart disease, in particular among those with a history of invasive procedures.
authors.affiliation: Division of Public Health Science, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.|Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Bahareh
authors.identifier: http://orcid.org/0000-0002-7544-6475
authors.initials: B
authors.lastname: Eslami
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity / Q000639:trends; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: cardiac surgery; depression; developing country; grown up with CHD; mental health