Among adolescents and adults with congenital heart disease, mental illness is a significantly more prevalent comorbidity in those who experienced at least two cardiac procedures during a 3-year period or had greater lesion complexity than in others.
According to the study published in The American Journal of Cardiology, adolescents with congenital heart disease have a greater risk for being diagnosed with developmental disorders, anxiety disorders, attention, conduct, behavior, impulse control disorders and mood disorders; and adult experienced a higher prevalence of mood disorders, anxiety disorders and substance-related disorders.
“Understanding the link between congenital heart disease and mental illness is crucial in providing comprehensive, patient-centered cardiac and mental health care.” Amber D. Khanna, MD, MS, of the departments of internal medicine and pediatrics, divisions of cardiology at the University of Colorado, and colleagues wrote.
Using the population-level Colorado heart defect surveillance system, researchers analyzed the data of 2,192 adolescents aged 11 to 17 years (42% girls), and 6,924 adults aged 18 to 64 years (53% women), with congenital heart disease between 2011 and 2013.
This study aimed to evaluate the incidence of mental illness in adolescent and adult patients with congenital heart disease as well as study the relationship between age, defect severity and mental illness and determine how preexisting genetic syndromes may be related mental illness prevalence.
Researchers found that 20% of the adolescent cohort were diagnosed with a form of mental illness, the most frequent including developmental disorders (8%), anxiety disorders (6%), attention, conduct, behavior, impulse control disorders (6%) and mood disorders (5%).
Of the adult cohort, 33% had some form of mental illness, most frequently mood disorders (13%), anxiety disorders (13%), and substance-related disorders (6%).
In both adolescents and adults with congenital heart disease, researchers found the following associations between the disease, treatment and mental illness:
Greater lesion complexity was linked to increased odds of anxiety and developmental disorders;
Receiving at least two cardiac procedures during the 3-year surveillance period lead to a threefold increase in the likelihood of mental illness diagnosis in adolescents and a 4.5-fold increase in adults; and
Patients with a genetic syndrome were also more likely to be diagnosed with a mental illness.
“Providers involved in the care of patients with a [congenital heart disease] should develop mechanisms to screen for mental illness and make appropriate referrals to mental health specialists for this population,” the researchers wrote. .”