Abstract 2422: Depression and Anxiety in Adult Patients with Congenital Heart Disease

Abstract

Background: Advances in the management of congenital heart disease (CHD) have resulted in increased survival of patients (pts) into adulthood, but those pts may encounter new medical and social problems in adulthood. Further, even if their medical condition may be good, social adaptation may be insufficient because of the psychiatric and/or psychological problems. However, little is known about psychosocial functioning of adults with CHD. The aim of this study was to evaluate psychopathological problems in adult pts with CHD. Methods: We evaluated psychopathological adjustment in 60 consecutive adult pts (20 –52 yrs of age) with CHD, who were hospitalized at our institute, including tetralogy of Fallot (9 pts), transposition of the great arteries (8 pts), single ventricle (7 pts), tricuspid atresia (5 pts), ventricular septal defect (3 pts), and miscellaneous (28 pts). Severity of cardiac conditions, psychiatric/ psychological symptoms, education, and career were assessed, and psychiatric analysis was performed in each patient. We used a standardized semi-structured psychiatric interview with the self-administered scale Minnesota Multiphasic Personality Inventory (MMPI). Results: 17% (10 pts) had clinical symptoms of depression and anxiety, and these pts met the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) for depression and anxiety, based on the diagnostic interview and MMPI. In addition, 23% (14 pts) showed abnormality in several scales, such as hypochondriasis, depression, and hysteria in MMPI, although they did not meet the criteria of psychopathology. In these pts, emotional problems were expressed as physical and general malaise in MMPI data. A statistically significant correlation was observed between the MMPI data and medical severity. The MMPI data did not correlate with the social background, such as education and work experience. Conclusions: The frequency of depression and anxiety is high in adults with CHD, especially in severe CHD, irrespective of education and career. Even if there may be no psychological symptoms and pts appear to be well adapted, there is a potential risk of depression and anxiety in adults with CHD. Optimal psychiatric interventions remain to be clarified.