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The impact of severe congenital heart disease on physical and psychosocial functioning in adolescents

Published online by Cambridge University Press:  19 August 2008

Per G. Bjørnstad*
Affiliation:
From the Departments of Pediatric Cardiology, Child and Adolescent Psychiatry and Thoracic and Cardiovascular Surgery, Rikshospitalet, The National Hospital, Oslo
Ingrid Spurkland
Affiliation:
From the Departments of Pediatric Cardiology, Child and Adolescent Psychiatry and Thoracic and Cardiovascular Surgery, Rikshospitalet, The National Hospital, Oslo
Harald L. Lindberg
Affiliation:
From the Departments of Pediatric Cardiology, Child and Adolescent Psychiatry and Thoracic and Cardiovascular Surgery, Rikshospitalet, The National Hospital, Oslo
*
Correspondence to Dr. Per G. Bjørnstad, Pediatric Cardiology, Rikshospitalet, The National Hospital, University of Oslo, Pilestredet 32, N-0027 Oslo, Norway. Tel. 47-228 690 92; Fax. 47-228 691 01.

Abstract

A study was made of 26 adolescents, aged from 13 to 18 years, with different types of severe congenital heart disease, assessing their somatic condition and its impact on mental health and psychosocial functioning. Physical capacity was reduced, more pronounced in girls than in boys, along with an increased rate of psychiatric problems. Associations were found between physical capacity and psychosocial functioning, and between psychosocial functioning and chronic family difficulties. On the other hand, half the patients studied achieved fair function, both physically and with regard to their mental health. The degree of reduced physical capacity is an important etiological factor for impaired mental health in patients with congenital heart disease. This knowledge should be taken into account when dealing with this group of patients. A good social network seems to be a protective factor. It will probably be rewarding to give patients and their families not only an optimal medical follow-up, but also psychological, practical and financial support to improve or create such a network.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1995

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References

Landtman, B, Valanne, EH, Aukee, M.Emotional implications of heart disease. A study of 256 children with real and “imaginary” heart disease. Ann Paediat Fen 1968; 14: 7192.Google ScholarPubMed
Linde, LM, Rasof, B, Dunn, OJ, Rabb, E.Attitudinal factors in congenital heart disease. Pediatrics 1966; 38: 92101.CrossRefGoogle ScholarPubMed
Linde, LM.Psychiatric aspects of congenital heart disease. Psychiat Clin N Amer 1982; 5: 399406.CrossRefGoogle ScholarPubMed
Garson, A Jr, Williams, RB Jr, Rechless, J.Long-term follow-up of patients with tetralogy of Fallot: Physical health and psychopathology. J Pediatr 1974; 85: 429433.CrossRefGoogle ScholarPubMed
O'Dougharty, M, Wright, FS, Garmez, N, Loewenson, RB, Torres, F.Later competence and adaption in infants who survive severe heart defects. Child Development 1983; 54: 11291142.CrossRefGoogle Scholar
Kramer, HH, Awiszus, D, Sterzel, U, van Halteren, A, Classen, R.Development of personality and intelligence in children with congenital heart disease. J Child Psychol Psychiat 1989; 30: 299308.CrossRefGoogle ScholarPubMed
New York Heart Association, Inc. Nomenclature and criteria for diagnoses of diseases of the heart and blood vessels, 5th ed. by Criteria, Commina, Pardle, EB (chairman). American Heart Association, New York, 1953.Google Scholar
Hodges, K, McKnew, D, Cytryn, L, Stern, L, Kline, J.The Child Assessment Schedule (CAS) diagnostic interview: A report on reliability and validity. J Am Acad Child Psychiat 1982; 21: 468473.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd edition. American Psychiatric Association, Washington DC, 1980.Google Scholar
Schaffer, D, Gould, US, Brasic, J, Ambrosini, P, Fisher, P, Bird, H, Aluwahlia, S.A children's global assessment scale (CGAS). Psychopharm Bull 1985; 21: 747748.Google Scholar
Steinhausen, HC.Global assessment of child psychopathology. J Am Acad Child Adol Psychiat 1987; 2: 203206.CrossRefGoogle Scholar
Bird, HR, Canino, G, Rubrio-Stripee, M, Ribera, J.Further measures of the psychometric properties of the Children's global assessment scale. Arch Gen Psychiatr 1987; 44: 821824.CrossRefGoogle ScholarPubMed
Achenbach, TM, Edelbrock, CS.Manual for the Child Behavior Checklist and Revised Child Behavior Profile. University of Vermont, Burlington, 1983.Google Scholar
Vandvik, IH, Høyeraal, HM, Fagertun, H.Chronic Family difficulties and stressful life events in recent onset juvenile arthritis.J Rheumatol 1989; 16: 10881092.Google ScholarPubMed
Bjørnstad, P, Lindberg, H, Spurkland, I.Unge hjerter i faresonen. Monography, TANO A.S., Oslo, 1990.Google Scholar
Skrede, K.Sosioøkonomisk klassifisering av yrker i Norge (Socioeconomic Classification of Occupations in Norway) 1960. INAS Report, Oslo, 1971; No 71–1.Google Scholar
Verhulst, FC, Akkerhuis, GW, Althaus M: Mental health in Dutch children. I. A cross-cultural comparison. Acta Psych Scand 1985; 72(Suppl 323yes).CrossRefGoogle Scholar
Steinhausen, H-C and Kies, H.Comparative studies of ulcerative colitis and Crohn's disease in children and adolescents. J Child Psychol Psychiat 1982; 23: 3342.CrossRefGoogle ScholarPubMed
Wallander, JL, Varni, JW, Babani, L, Tweddle Banis, H, Thompson Wilcox, K.Children with chronic physical disorders: maternal reports of their psychological adjustment. J Pediatr Psychol 1988; 13: 197212.CrossRefGoogle ScholarPubMed
Engstrøm, I.Mental health and psychological Functioning in children and adolescents with inflammatory bowel disease: A comparison with children having other chronic illnesses and with healthy children. J Child Psychol Psychiat 1992; 33:563582.CrossRefGoogle ScholarPubMed
North, CS, Clouse, RE, Spitznagel, EL, Alpers, DH.The relation of ulcerative colitis to psychiatric factors: A review of findings and methods. Am J Psychiatry 1990; 147: 974981.Google ScholarPubMed
Rutter, M, Sandberg, S.Psychosocial stressors; concepts, causes and effects. Eur Child Adolesc Psychiatry 1992; 1: 313.CrossRefGoogle Scholar
Puig-Antic, J, Chambers, WJ, Tabrizi, MA. The clinical assessment of current depressive episodes in children and adolescents: Interviews with parents and children. In: Cantwell, DP, Carlson, GA (eds). Affective Disorders in Childhood and Adolescence: An Update. Spectrum Publications, New York, 1983.Google Scholar
Rutter, M.Resilience in the face of adversity: protective factors and resistance to psychiatric disorder. Brit J Psych 1985; 147: 598–564.CrossRefGoogle ScholarPubMed