Are kids with congenital heart disease at greater risk of mental health issues?

For children and adolescents with congenital heart disease there is little available information on correlating mental health issues such as anxiety, depression, and attention-deficit/hyperactivity disorder. Now, a new report in Pediatrics offers some important data to guide future care.¹

The investigators ran a comparative cross-sectional study that used electronic medical records from a large tertiary care hospital between 2011 and 2016. A child or teenager was included if he or she was aged 4 to 17 years and had >1 hospitalization or emergency department visit. Potential participants were excluded if they had arrhythmias or were being treated with either clonidine or benzodiazepines.

Of the 118,785 total patients, 1164 were identified as having congenital heart disease. Among these patients, 18.2% of the patients with congenital heart disease had either a diagnosis or medication for anxiety or depression. In comparison, 5.2% of patients who did not have congenital heart disease had the same. Overall, the investigators found that all children and teenagers with congenital heart disease had much higher odds of anxiety and/or depression or ADHD. Additionally, children who were aged 4 to 9 years and had simple congenital heart disease had ∼5 times higher odds (odds ratio [OR]: 5.23; 95% CI: 3.87–7.07) and children with complex single ventricle congenital heart disease had ∼7 times higher odds (OR: 7.46; 95% CI: 3.70–15.07) of diagnosis or treatment for either anxiety and/or depression. Children who were a minority or who had no insurance were found to be significantly less likely to be either diagnosed or treated for any mental health issue. This was true regardless of the child’s disease severity.

The researchers concluded that children with congenital heart disease had significantly higher odds of mental health issues when compared with children who did not have the disease, true for all levels of the disease’s severity. They also concluded that mental health screenings should be strongly considered for all pediatric patients with congenital heart disease.

Reference

1. Gonzalez V, Kimbro R, Cutitta K, et al. Mental Health Disorders in Children With Congenital Heart Disease. Pediatrics. January 4, 2021. Epub ahead of print. doi:10.1542/peds.2020-1693