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Anxiety and Depression in Adults With Congenital Heart Disease
Quick Takes
- Elevated symptoms of either anxiety or depression were present in 30.1% of ACHD patients (18.3% anxiety alone, 2.9% depression alone, and 8.9% for both).
- Patient-reported quality of life and perceived health status were lower in patients with elevated anxiety and depression scores.
Study Questions:
What is the prevalence of elevated levels of anxiety and depression in adults with congenital heart disease (ACHD)?
Methods:
A multicenter international study was performed across 15 countries. Participants completed the Hospital Anxiety and Depression Scale (HADS) including subscales for symptoms of anxiety (HADS-A) and depression (HADS-D). Subscale scores of ≥8 indicated clinically elevated symptoms. Participants also completed 0-100 analog scales for quality of life (QOL) and health status.
Results:
Of 3,815 participants (mean age 34.8 ± 12.9 years; 52.7% female), 30.1% had elevated symptoms in one or both subscales. Elevated symptoms on HADS-A only occurred in 18.3%, elevated symptoms on HADS-D only occurred in 2.9%, and 8.9% of participants had elevated symptoms on both subscales. Percentages varied between countries. Both QOL and health status decreased in accordance with increasing HADS-A and HADS-D symptom categories.
Conclusions:
The authors conclude that almost one-third of adults with CHD reported elevated symptoms of depression and/or anxiety, which were associated with lower QOL and perceived health status.
Perspective:
This large, international study adds to our body of knowledge related to the significance of anxiety and depression in ACHD. While the study showed significant prevalence of symptoms of anxiety and depression, it was not designed to compare the prevalence for ACHD patients with that of the general population. While it is reasonably common to screen for anxiety and depression in adults coming through ACHD clinics, it is important to link those patients with positive screens to resources to address these issues.
Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Congenital Heart Disease, CHD and Pediatrics and Prevention
Keywords: Anxiety, Depression, Heart Defects, Congenital
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