Institution of Health Sciences, Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
J Psychosom Res. 2013 Jan;74(1):49-56. doi: 10.1016/j.jpsychores.2012.10.006. Epub 2012 Nov 11.
Despite the improvement in life-expectancy of adults with congenital heart disease, they may experience unique medical and social challenges that could impact on their psychological functioning. The aims of this study were to address the experience of anxiety, depressive and somatic symptoms among adults with congenital heart disease in comparison with that of non-heart diseased persons considering the role of various factors (e.g. socio-economic).
In cross-sectional case-control study, the participants consisted of 347 patients with congenital heart disease (18-64 years, 52.2% female) and 353 matched (by sex/age) non-heart diseased persons. The participants completed a questionnaire. The data were analyzed with bivariate and multivariate methods.
In bivariate analyses, scores in anxiety and somatic symptoms were higher among patients than the healthy controls (both at p≤0.001), whereas the groups did not differ in depressive symptoms. Following multiple-linear-regression-analyses, only the association between congenital heart disease and somatic symptoms was confirmed. Among the patients, perceived financial strain was significantly related to anxiety, depressive and somatic symptoms; lower perceived social support to anxiety and depression; and low annual income to somatic symptoms. Additionally, somatic symptoms were associated with anxiety and depressive symptoms, and vice versa. And no medical variables were related to anxiety, depressive and somatic symptoms.
Congenital heart disease was only independently associated with somatic symptoms. Financial strain, social support and co-existence of emotional distress with somatic symptoms should be considered in developing appropriate interventions to improve the well-being of patients with congenital heart disease. However, longitudinal research is warranted to clarify causality.
尽管成人先天性心脏病患者的预期寿命有所提高,但他们可能会经历独特的医疗和社会挑战,这可能会影响他们的心理功能。本研究的目的是比较成人先天性心脏病患者与非心脏病患者的焦虑、抑郁和躯体症状体验,并考虑各种因素(如社会经济状况)的作用。
在横断面病例对照研究中,参与者包括 347 名先天性心脏病患者(18-64 岁,52.2%为女性)和 353 名匹配的非心脏病患者(按性别/年龄匹配)。参与者完成了一份问卷。使用双变量和多变量方法对数据进行分析。
在双变量分析中,患者的焦虑和躯体症状评分高于健康对照组(均为 p≤0.001),而两组在抑郁症状方面没有差异。经过多元线性回归分析,仅证实了先天性心脏病与躯体症状之间的关联。在患者中,感知到的经济压力与焦虑、抑郁和躯体症状显著相关;感知到的社会支持与焦虑和抑郁相关;而年收入低与躯体症状相关。此外,躯体症状与焦虑和抑郁症状相关,反之亦然。并且没有医学变量与焦虑、抑郁和躯体症状相关。
先天性心脏病仅与躯体症状独立相关。在制定改善先天性心脏病患者幸福感的适当干预措施时,应考虑经济压力、社会支持以及情绪困扰与躯体症状并存的问题。然而,需要进行纵向研究以澄清因果关系。