Objectives: To evaluate the prevalence and contributory factors of depression and anxiety in adolescents with heart disease (HD).
Methods: A cohort of adolescents with HD recruited from an ambulatory setting at a tertiary centre and a private service completed questionnaires further supplemented by clinical information provided by the attending cardiologists. The questionnaires included the Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS), Life Orientation Test-Revised (LOT-R), Sense of Coherence-13 and a researcher-designed questionnaire to assess the adolescent’s knowledge of their specific cardiac condition.
Results: 121 patients were recruited between May 2007 and August 2008. They were aged from 12 to 20 years. The majority (98%) were in NYHA I, having minor abnormalities or residual lesions following surgery or catheter intervention. The abnormities included congenital HD (92%), acquired HD and arrhythmias. A third (35%, 42/121) of patients were above the cut-off score for probable depression or anxiety, another 21% (25/121) scored in the range for possible depression or anxiety. Scores on the HADS were significantly negatively associated with optimism (Pearson correlation, r=-0.496, p< 0.01), social support (r=-0.316, p< 0.01) and sense of coherence (r=-0.274, p<0.01). No relationship was found between patient’s scores on the HADS and their knowledge and understanding of their cardiac problem, the severity of their HD, their age or gender.
Conclusions: Depression and anxiety may be common in adolescents with HD. Feelings of optimism, a strong sense of coherence and good social support are protective factors.