Bromberg Jonas I, Beasley Pamela J, D'Angelo Eugene J, Landzberg Michael, DeMaso David Ray
Children's Hospital Boston & Harvard Medical School, Departments of Psychiatry and Cardiology, Boston, Massachusetts 02115, USA.
Heart Lung. 2003 Mar-Apr;32(2):105-10. doi: 10.1067/mhl.2003.26.
To examine the presence of depression and anxiety in adults with congenital heart disease and the association of medical severity with depression and anxiety.
Prospective, pilot study.
An adult outpatient cardiology clinic in university-affiliated children's hospital in Northeast.
Twenty-two adult patients with congenital heart disease followed in an adult cardiology clinic. Patients were selected who had no evidence of emotional or behavioral difficulties, (ie, no symptoms of depression or anxiety). Outcome Measures Standardized semi-structured psychiatric interview with structured checklist eliciting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for depressive and anxiety disorders, Brief Symptom Inventory (BSI), and the Cardiologist's Perception of Medical Severity scale.
Among patients who had been assumed to be "well adjusted," 36.4% were experiencing a diagnosable psychiatric disorder, with anxiety or depressive symptoms being prominent. There were 6 patients (27.3%) who had BSI scores above 63 indicating pathological emotional functioning. There was significant convergent validity between the clinical diagnoses of depression and anxiety using both diagnostic interviews to identify DSM-IV diagnostic conditions and the BSI. There were significant associations between patient's medical severity scores and with the DSM-IV diagnosis of depression and the BSI global index score and depression subscale.
This pilot study raises important concerns about the emotional functioning of many adults facing congenital heart disease, particularly those with complex lesions. From a clinical perspective, this work suggests that health care professionals should be alert for emotional difficulties and the possible need for psychological intervention for adult survivors of congenital heart disease even among those that are seemingly emotionally well adjusted.
研究先天性心脏病成人患者中抑郁和焦虑的存在情况，以及疾病严重程度与抑郁和焦虑之间的关联。
前瞻性试点研究。
东北部大学附属医院的成人门诊心脏病诊所。
在成人心脏病诊所接受随访的22例先天性心脏病成人患者。入选的患者无情绪或行为障碍证据（即无抑郁或焦虑症状）。结局指标 采用标准化半结构化精神科访谈，使用结构化检查表引出《精神障碍诊断与统计手册》第四版（DSM-IV）中抑郁和焦虑障碍的诊断标准、简明症状量表（BSI）以及心脏病专家对疾病严重程度的感知量表。
在被认为“适应良好”的患者中，36.4%存在可诊断的精神障碍，焦虑或抑郁症状较为突出。有6例患者（27.3%）的BSI评分高于63，表明存在病理性情绪功能。使用两种诊断访谈来确定DSM-IV诊断情况以及BSI对抑郁和焦虑进行临床诊断之间存在显著的聚合效度。患者的疾病严重程度评分与DSM-IV抑郁诊断、BSI总体指数评分及抑郁分量表之间存在显著关联。
这项试点研究引发了对许多患有先天性心脏病的成年人，尤其是那些患有复杂病变的成年人情绪功能的重要关注。从临床角度来看，这项研究表明，医疗保健专业人员应警惕先天性心脏病成年幸存者的情绪问题以及可能需要的心理干预，即使是那些看似情绪适应良好的患者。
