The influence of congenital heart disease on psychological conditions in adolescents and adults after corrective surgery.

OBJECTIVE

The present study was designed to examine psychological characteristics of adolescents and adults with operated congenital heart disease (ACHD). Particularly it was to be examined whether cardiological parameters may be associated with subjectively perceived impairments and measures of psychological distress.

PATIENTS: A total of 361 men (209) and women (152) between 14 and 45 years underwent medical checkups and an interview on psychological and sociological issues.

SETTING

The medical part consisted of a complete cardiological examination including the classification of residual symptoms according to the New York Heart Association (NYHA), and spiroergometry. The Brief Symptom Inventory was used for depicting current psychological and somatic symptoms. These were assessed on 9 subscales: somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism.

RESULTS

The analyses revealed statistically significant associations between the degree of NYHA class and psychological symptoms. These findings could not be reproduced for physical fitness as measured by peak oxygen consumption. No gender differences emerged.

CONCLUSIONS

Our results suggest that psychological measures of ACHD are not directly dependent on their physical fitness or on the severity of residual symptoms. Instead, patients' subjective appraisal of their disease severity and the conviction to what degree one can depend on the operated heart may be important determinants of psychological states.