Abstract 11149: Psychological Functioning and Parameters of Physiological Status in Youth with Fontan Circulation

Abstract

Individuals with Fontan circulation (FC) are at high risk for physical and psychological problems. Many have poor growth, low weight gain, and low oxygen saturation (O2 sat). They also often have learning problems, inattention, and mood/anxiety disorders. Research on associations between these physical and mental challenges is limited. This study explores potential relations among these variables in a cohort with FC. We hypothesize that poorer growth, weight, and O2 sat are associated with greater problems with school, mood/anxiety, and inattention. A team, including pediatric cardiologist, psychologist, and other medical specialties, evaluated participants in our FORWARD program, a dedicated multidisciplinary clinic for patients with FC. Data were extracted from medical records. Height, weight, and resting O2 sat were measured at the clinic visit. Patients completed a psychological screening questionnaire (BASC-3); scales selected for analyses were based on commonly recognized problems in FC: school (academic difficulties, negative school attitude), internalizing (mood/anxiety), and attention problems. Sample consisted of 45 subjects; 53% male, 84% White, 81% had private health insurance. Plurality had hypoplastic left heart syndrome (47%). Mean age was 12.7 + 2.7 years, O2 sat 93.9 + 2.7 %, height z-score -0.58 + 1.42, and weight z-score -0.23 + 1.43. Mean values on all psychological measures were not indicative of problems. Height and weight were not related to psychological measures. O2 sat was inversely correlated with school problems (r= -.350, p= .018). Internalizing (r= .503, p< .001 ) and attention (r= .427, p= .002) problems were correlated with school problems. O2 sat, internalizing and attention problems were entered into a regression predicting school problems; the model explained 35.4% of the variance (p< .001). School problems of individuals with FC are likely determined by both physical and psychological factors. In our relatively small and young cohort of patients, lower O2 sat may reflect relative overall FC unwellness, and is associated with greater psychological health challenges. Exploration of potential mechanisms underlying relations between physical and psychological health in those with FC is warranted.