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Development and persistence of depressive symptoms in adolescents with CHD

Published online by Cambridge University Press:  15 September 2015

Koen Luyckx ,
Jessica Rassart ,
Eva Goossens ,
Silke Apers ,
Leen Oris  and
Philip Moons
Koen Luyckx*
Affiliation:
School Psychology and Child and Adolescent Development, KU Leuven, Leuven, Belgium
Jessica Rassart
Affiliation:
School Psychology and Child and Adolescent Development, KU Leuven, Leuven, Belgium
Eva Goossens
Affiliation:
Department of Public Health and Primary Care, KU Leuven – University of Leuven, Leuven, Belgium Research Foundation Flanders, Belgium
Silke Apers
Affiliation:
Department of Public Health and Primary Care, KU Leuven – University of Leuven, Leuven, Belgium
Leen Oris
Affiliation:
School Psychology and Child and Adolescent Development, KU Leuven, Leuven, Belgium
Philip Moons
Affiliation:
Department of Public Health and Primary Care, KU Leuven – University of Leuven, Leuven, Belgium The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark Institute of Health and Care Sciences, Gothenburg University, Gothenburg, Sweden
*
Correspondence to: K. Luyckx, School Psychology and Child and Adolescent Development, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium. Tel: 0032 16 325978; E-mail: koen.luyckx@ppw.kuleuven.be
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Abstract

Patients with CHD are vulnerable to psychiatric disorders. The present study compared baseline depressive symptoms between adolescents with CHD and community adolescents, and also assessed the development and persistence of depressive symptoms in patients. We examined the implications of persistent depressive symptoms towards quality of life and patient-reported health. In total, 296 adolescents with CHD participated in a four-wave longitudinal study, with 9-month intervals, and completed measures of depressive symptoms – Center for Epidemiologic Studies Depression Scale (CES-D) – at time points one to four and of quality of life – linear analogue scale (LAS) – and patient-reported health – LAS and Pediatric Quality of Life Inventory – at T (time) 4. Information about diagnosis, disease complexity, and previous heart surgery was collected from medical records. At T1, 278 patients were matched 1:1 with community adolescents, based on sex and age. The findings of this study indicate that patients scored significantly lower on depressive symptoms compared with community adolescents. Depressive symptoms in the total patient sample were stable over time and were unrelated to disease complexity. Based on conventional cut-off scores of the CES-D, substantial individual differences existed in the extent to which depressive symptoms persisted over time: 12.2% of the patients reported elevated depressive symptoms at minimally three out of the four time points. Especially physical functioning, cardiac symptoms, and patient-reported health at T4 were predicted by persistent depressive symptoms, even when controlling for the level of depressive symptoms at T4. Our findings indicate that those involved in the care of adolescents with CHD should remain vigilant to persistent depressive symptoms and arrange timely referral to mental healthcare services.

Keywords

Heart defectscongenitaladolescencedepressive symptomsdevelopment

Information

Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1115 - 1122
Copyright
© Cambridge University Press 2015 

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References

1. van der Linde, D, Konings, EEM, Slager, MA, et al. Birth prevalence of congenital heart disease worldwide. J Am Coll Cardiol 2011; 58: 2241–2247.Google Scholar
2. Moons, P, Bovijn, L, Budts, W, et al. Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970-1992 in Belgium. Circulation 2010; 122: 2264–2272.CrossRefGoogle Scholar
3. Karsdorp, PA, Everaerd, W, Kindt, M, Mulder, BJM. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 2007; 32: 527–541.Google Scholar
4. Kovacs, AH, Saidi, AS, Kuhl, EA, et al. Depression and anxiety in adult congenital heart disease: predictors and prevalence. Int J Cardiol 2009; 137: 158–164.Google Scholar
5. Kovacs, AH, Moons, P. Psychosocial functioning and quality of life in adults with congenital heart disease and heart failure. Heart Fail Clin 2014; 10: 35–42.Google Scholar
6. Lichtman, JH, Froelicher, ES, Blumenthal, JA, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: review and recommendations. A scientific statement from the American Heart Association. Circulation 2014; 129: 1350–1369.Google Scholar
7. Kourkoveli, P, Rammos, S, Parissis, J, Maillis, A, Kremastinos, D, Paraskevaidis, I. Depressive symptoms in patients with congenital heart disease: incidence and prognostic value of self-rating depression scales. Congenit Heart Dis 2014; 10: 240–247.Google Scholar
8. Lewinsohn, PM, Hops, H, Roberts, RE, Seeley, JR, Andrews, JA. Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J Abnorm Psychol 1993; 102: 133–144.Google Scholar
9. Harrington, R, Fudge, H, Rutter, M, Pickles, A, Hill, J. Adult outcomes of childhood and adolescent depression. Arch Gen Psychiatry 1990; 47: 465–473.Google Scholar
10. Mitchell, SC, Korones, SB, Berendes, HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation 1971; 43: 323–332.Google Scholar
11. Van der Velde, ET, Vriend, JWJ, MMAM, Mannens, et al. CONCOR, an initiative towards a national registry and DNA-bank of patients with congenital heart disease in the Netherlands: rationale, design, and first results. Eur J Epidemiol 2005; 20: 549–557.CrossRefGoogle Scholar
12. Warnes, CA, Liberthson, R, Danielson, GK, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001; 37: 1170–1175.Google Scholar
13. Radloff, LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 3: 385–401.Google Scholar
14. Cohen, M, Mansoor, D, Langut, H, Lorber, A. Quality of life, depressed mood, and self-esteem in adolescents with heart disease. Psychosom Med 2007; 69: 313–318.CrossRefGoogle ScholarPubMed
15. Roberts, RE, Andrews, JA, Lewinsohn, PM, Hops, H. Assessment of depression in adolescents using the Center for Epidemiologic Studies Depression Scale. J Consult Clin Psychol 1990; 2: 122–128.Google Scholar
16. Moons, P, Van Deyk, K, Marquet, K, et al. Individual quality of life in adults with congenital heart disease: a paradigm shift. Eur Heart J 2005; 26: 298–307.Google Scholar
17. Moons, P, Van Deyk, K, De Bleser, L, et al. Quality of life and health status in adults with congenital heart disease: a direct comparison with healthy counterparts. Eur J Cardiovasc Prev Rehabil 2006; 13: 407–413.Google Scholar
18. Uzark, K, Jones, K, Burwinkle, TM, Varni, JW. The Pediatric Quality of Life Inventory™ in children with heart disease. Prog Pediatr Cardiol 2003; 18: 141–148.Google Scholar
19. Varni, JW, Seid, M, Murtin, PS. The PedsQL™ measurement model for the pediatric quality of life inventory. Med Care 1999; 37: 126–139.Google Scholar
20. Müller, J, Hess, J, Hager, A. Minor symptoms of depression in patients with congenital heart disease have a larger impact on quality of life than limited exercise capacity. Int J Cardiol 2012; 154: 265–269.Google Scholar
21. Roberts, RE, Lewinsohn, PM, Seeley, JR. Screening for adolescent depression: a comparison of depression scales. J Am Acad Child Adolesc Psychiatry 1991; 30: 58–66.Google Scholar
22. Rushton, JL, Forcier, M, Schectman, RM. Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health. J Am Acad Child Adolesc Psychiatry 2002; 41: 199–205.CrossRefGoogle ScholarPubMed
23. Van Rijen, EHM, EMWJ, Utens, Roos-Hesselink, JW, et al. Longitudinal development of psychopathology in an adult congenital heart disease cohort. Int J Cardiol 2005; 99: 315–323.Google Scholar
24. Fredriksen, PM, Diseth, TH, Thaulow, E. Children and adolescents with congenital heart disease: assessment of behavioural and emotional problems. Eur Child Adolesc Psychiatry 2009; 18: 292–300.CrossRefGoogle ScholarPubMed
25. Warnes, CA, Williams, RG, Bashore, TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2008; 118: e714–e833.Google Scholar
26. Eslami, B, Sundin, O, Macassa, G, Khankeh, HR, Soares, JJF. Anxiety, depressive and somatic symptoms in adults with congenital heart disease. J Psychosom Res 2013; 74: 49–56.Google Scholar
27. Rose, M, Köhler, K, Köhler, F, Sawitzky, B, Fliege, H, Klapp, BF. Determinants of the quality of life of patients with congenital heart disease. Qual Life Res 2005; 14: 35–43.Google Scholar
28. DeMaso, DR, Campis, LK, Wypij, D, Bertram, S, Lipshitz, M, Freed, M. The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Pediatr Psychol 1991; 16: 137–149.Google Scholar
29. Wang, Q, Hay, M, Clarke, D, Menahem, S. The prevalence and predictors of anxiety and depression in adolescents with heart disease. J Pediatr 2012; 161: 943–946.CrossRefGoogle ScholarPubMed
30. Chen, CA, Liao, SC, Wang, JK, et al. Quality of life in adults with congenital heart disease: biopsychosocial determinants and sex-related differences. Heart 2011; 97: 38–43.Google Scholar