Children and adolescents with a congenital heart disease are at greater risk than those without of developing depression, anxiety, or attention-deficit/hyperactivity disorder (ADHD), according to a report in Pediatrics.
“Our data support the notion that the population of patients with [congenital heart disease], regardless of disease severity, would likely benefit from mental health screening and evidence-based therapy earlier in childhood,” wrote Vincent Gonzalez, M.D., of Baylor College of Medicine and colleagues.
Gonzalez and colleagues compiled electronic health record data from 118,785 youth aged 4 to 17 years who were hospitalized or seen in the emergency department at Texas Children’s Hospital between 2011 and 2016. They compared the rates of depression, anxiety, and ADHD among children with or without congenital heart disease, based on receiving a diagnosis and/or medication for one of these disorders. (Since anxiety and depression are treated with similar medications, the authors condensed these disorders into one category.)
Of the 118,785 youth in the sample, 1,164 had congenital heart disease, split roughly equally between simple and complex defects, as defined by the American Heart Association/American College of Cardiology guidelines. Overall, 18.2% and 5.1% of youth with congenital heart disease had a diagnosis or medication for anxiety/depression and ADHD, respectively, compared with 5.2% and 2.1%, respectively, of youth with no congenital heart disease. The prevalence of anxiety/depression or ADHD was statistically higher in children with congenital heart disease across all age groups studied: 4 to 9 years, 10 to 13 years, and 14 to 17 years. The odds of depression/anxiety or ADHD was about the same in children with simple or complex congenital heart disease.
Gonzalez and colleagues also found that minority and uninsured youth were significantly less likely to be diagnosed or treated for anxiety/depression or ADHD compared with white and insured youth, respectively, regardless of congenital heart disease severity. “[T]hese data underscore the importance of recognizing potential racial or ethnic bias in diagnosing mental health in children with [congenital heart disease], as well as enabling insurance coverage for treating these disorders,” they wrote.
For related information, see the Psychiatric News article “Acquired Mutations Link Congenital Heart Disease, Neurodevelopmental Disorders.”
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