Anxiety and Depression in Adults With Congenital Heart Disease.
Journal
Journal of the American College of Cardiology
Journal Volume
83
Journal Issue
3
Start Page
430
End Page
441
ISSN
1558-3597
Date Issued
2024-01-23
Author(s)
Kovacs, Adrienne H
Luyckx, Koen
Thomet, Corina
Budts, Werner
Enomoto, Junko
Sluman, Maayke A
Jackson, Jamie L
Khairy, Paul
Cook, Stephen C
Chidambarathanu, Shanthi
Alday, Luis
Estensen, Mette-Elise
Dellborg, Mikael
Berghammer, Malin
Johansson, Bengt
Mackie, Andrew S
Menahem, Samuel
Caruana, Maryanne
Veldtman, Gruschen
Soufi, Alexandra
Abstract
A comprehensive understanding of adult congenital heart disease outcomes must include psychological functioning. Our multisite study offered the opportunity to explore depression and anxiety symptoms within a global sample. In this substudy of the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults With Congenital Heart Disease-International Study), the authors we investigated the prevalence of elevated depression and anxiety symptoms, explored associated sociodemographic and medical factors, and examined how quality of life (QOL) and health status (HS) differ according to the degree of psychological symptoms. Participants completed the Hospital Anxiety and Depression Scale, which includes subscales for symptoms of anxiety (HADS-A) and depression (HADS-D). Subscale scores of 8 or higher indicate clinically elevated symptoms and can be further categorized as mild, moderate, or severe. Participants also completed analogue scales on a scale of 0 to 100 for QOL and HS. Analysis of variance was performed to investigate whether QOL and HS differed by symptom category. Of 3,815 participants from 15 countries (age 34.8 ± 12.9 years; 52.7% female), 1,148 (30.1%) had elevated symptoms in one or both subscales: elevated HADS-A only (18.3%), elevated HADS-D only (2.9%), or elevations on both subscales (8.9%). Percentages varied among countries. Both QOL and HS decreased in accordance with increasing HADS-A and HADS-D symptom categories (P < 0.001). In this global sample of adults with congenital heart disease, almost one-third reported elevated symptoms of depression and/or anxiety, which in turn were associated with lower QOL and HS. We strongly advocate for the implementation of strategies to recognize and manage psychological distress in clinical settings. (Patient-Reported Outcomes in Adults With Congenital Heart Disease [APPROACH-IS]; NCT02150603).
Subjects
adult congenital heart disease
anxiety
depression
quality of life
SDGs
Type
journal article