Burden of Depression, Anxiety, and Stress in Caregivers at Congenital Heart Surgery Clinic.

OBJECTIVE(S): Mental health concerns (MHCs) are prevalent in caregivers of children with congenital heart disease (CHD) and fluctuate throughout the CHD care journey. The period leading up to congenital heart surgery (CHS) consultation presents a potentially heightened timepoint for MHCs. This study aims to evaluate MHC prevalence among caregivers at the time of CHS consultation.

STUDY

DESIGN

This single-center retrospective review analyzed CHS consultations from 1/1/2019 to 10/31/2022. The Depression Anxiety Stress Scale-21 (DASS-21) was administered to caregivers attending CHS consultations. DASS-21 subscale scores for depression, anxiety, and stress were categorized as "no concerns" vs. "any concerns." Sociodemographic and clinical characteristics were collected. Univariate and multivariable analyses were performed.

RESULTS

A total of 373 caregiver DASS-21 assessments were identified. The median patient age was 45.6 months [IQR: 7.0-129.0], with 160 (42.8%) female and 219 (58.7%) covered by private insurance. Clinically, 47 (12.6%) patients had single-ventricle (SV) diagnoses, and 191 (51.2%) had a syndrome or chromosomal abnormality. MHC prevalence was notable among caregivers: 17.4% for depression, 29.2% for anxiety, and 34.9% for stress. Caregivers of uninsured children and those of patients with SV diagnoses had elevated odds of MHCs, especially in stress (OR 7.77;CI 1.60-37.58, p = 0.010). Higher number of previous surgeries in SV also correlated with increased caregiver stress (OR 1.35; CI 1.07-1.70, p = 0.010).

CONCLUSION(S): MHCs are common in caregivers at CHS consultation and are associated with both clinical and sociodemographic factors. Early identification of caregiver MHCs at CHS consultation may provide an opportunity for timely intervention and support prior to surgery.