Long-term psychological outcome of children after surgery for transposition of the great arteries.

Abstract

To assess the psychological consequences of a single congenital heart defect, we tested intellectual function, self-perception, "body image", child psychiatric symptoms and the family climate in 21 boys and 10 girls, at a mean age of 13.2 y, on average 11.5 y after surgery for transposition of the great arteries. Where applicable, test norms were used for comparison. WISC-R IQ tended to be slightly lower than that of the general population. Self-perception, as reflected on the "I think I am" test, was normal. "Body image" as measured by the "Draw-a-man" test was poor in the boys, but did not show a relationship with any other test tapping mental health. Six children (19%) had clinically significant child psychiatric symptoms, which is slightly more than expected, and were overrepresented in patients with poorer cardiac function. Five of these represented "internalizing" disorders. The patients' families scored higher than expected on the family climate "chaos" subscale, which has been demonstrated to be associated with the development of psychiatric symptoms. Overall, however, the children and their families were regarded as socially and psychologically well-functioning.