Congenital heart disease tied to higher burden of mental illnesses, ADHD

Anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) are prevalent among kids with congenital heart disease (CHD), a study reports.

The analysis included a total of 118,785 patients aged 4–17 years who had been hospitalized or visited an emergency department at least once. Of these, 1,164 patients had CHD. None of them had arrhythmias or been exposed to clonidine and/or benzodiazepines.

Most of the CHD patients had simple (47.7 percent) or complex nonsingle ventricle (NSV; 46.9 percent) lesions. Compared with controls, patients with CHD had more 4- to 9-year-olds (61.0 percent vs 53.6 percent), were more likely to be a boy (56.8 percent vs 52.0 percent), and to be privately insured (48.5 percent vs 38.6 percent).

Generally, children with versus without CHD were more likely to have anxiety and/or depression (18.2 percent vs 5.2 percent; p<0.05) or ADHD (5.1 percent vs 2.1 percent; p<0.05). This held true when children were stratified by age.

In logistic regression models, the estimates were most pronounced for anxiety and/or depression in the preadolescent group (aged 4–9 years) with simple CHD (odds ratio [OR], 5.23, 95 percent confidence interval [CI], 3.87–7.07) and complex single ventricle CHD (OR, 7.46, 95 percent CI, 3.70–15.07).

Finally, minority and uninsured youth were significantly less likely to be diagnosed or treated for anxiety and/or depression or ADHD, regardless of CHD severity.

The present data indicate that screening be considered for mental illnesses and ADHD in all patients with CHD.