Anxiety and Depression in Adults With Congenital Heart Disease

• Published in: Journal of the American College of Cardiology 2024-01, Vol.83 (3), p.430-441
• Main Authors: Kovacs, Adrienne H., Luyckx, Koen, Thomet, Corina, Budts, Werner, Enomoto, Junko, Sluman, Maayke A., Lu, Chun-Wei, 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, Jameson, Susan M., Callus, Edward, Kutty, Shelby, Oechslin, Erwin, Van Bulck, Liesbet, Moons, Philip
• Format: Article
• Language: English
• Subjects: Adult; adult congenital heart disease; anxiety; Anxiety - diagnosis; Anxiety - epidemiology; Anxiety - psychology; depression; Depression - diagnosis; Depression - epidemiology; Depression - etiology; Female; Health Sciences; Heart Defects, Congenital - complications; Heart Defects, Congenital - epidemiology; Humans; Hälsovetenskap; Male; Middle Aged; Nursing science; quality of life; Quality of Life - psychology; Vårdvetenskap; Young Adult
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2023.10.043

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