Anxiety and Depression in Adults With Congenital Heart Disease.
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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, APPROACH-IS Consortium, International Society for Adult Congenital Heart Disease
Аннотация
OBJECTIVES: 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.
METHODS: 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.
RESULTS: 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 < 0.001).
CONCLUSIONS: In this global sample of adults with congenital heart disease, almost one-third reported elevated symptoms of depression and/or anxiety, which in turn were associated with lower QOL and HS. We strongly advocate for the implementation of strategies to recognize and manage psychological distress in clinical settings. (Patient-Reported Outcomes in Adults With Congenital Heart Disease [APPROACH-IS]; NCT02150603).