Department of Psychology, Instituto Superior de Ciências da Saúde do Norte (CESPU), Gandra, Portugal.
BMJ Open. 2013 Jan 28;3(1):e001138. doi: 10.1136/bmjopen-2012-001138.
Our purpose was to study psychosocial adjustment and psychiatric morbidity of adolescents and young adults with congenital heart disease (CHD).
All assessment measures were obtained on a single occasion. Clinical data was obtained through the patient's clinical records.
A teaching and tertiary care facility in Porto, Portugal.
We evaluated 110 CHD patients (62 male) aged from 12 to 26 years (mean=18.00±3.617), 58 cyanotic. All assessment measures were obtained on a single occasion in a tertiary hospital. Demographic information and clinical history were collected.
Questionnaires regarded topics such as social support, family educational style, self-image and physical limitations, a standardised psychiatric interview Schedule for Affective Disorders and Schizophrenia-Lifetime version (SADS-L), and a self-report questionnaire on psychosocial adjustment, youth self-report or adult self-report. One of the relatives completed an observational version of the same questionnaire (child behaviour checklist (CBCL) or ABCL (adult behaviour checklist)).
We found a 21.8% lifetime prevalence of psychopathology, 31.3%, in females, 14.5% in males, showing a somewhat increased proneness in CHD patients. Females also showed worse psychosocial adjustment, with more somatic complaints (u=260 000; p=0.011), anxiety/depression (u=984 000; p=0.002), aggressive behaviour (u=920 500; p=0.001), attention problems (u=1123 500; p=0.027), thought problems (u=1069 500; p=0.010), internalisation (u=869 000; p=0.0) and externalisation (u=1163 000; p=0.05). Patients with severe CHD (u=939 000; p=0.03) and surgical repair (u=719 000; p=0.037) showed worse psychosocial adjustment. Those with poor social support showed more withdrawal (u=557 500; p=0.0) and social problems (u=748 500; p=0.023), and patients with unsatisfactory school performance revealed more anxiety/depression (u=916 000; p=0.02) and attention problems (u=861 500; p=0.007).
CHD males with good social support and good academic performance have a better psychosocial adjustment.
我们旨在研究先天性心脏病（CHD）青少年和年轻患者的社会心理适应和精神疾病发病率。
所有评估均在单次就诊时进行。临床数据通过患者的临床记录获得。
葡萄牙波尔图的一所教学和三级保健机构。
我们评估了 110 名 CHD 患者（62 名男性），年龄在 12 至 26 岁之间（平均 18.00±3.617），其中 58 名患者发绀。所有评估均在三级医院单次就诊时进行。收集了人口统计学信息和临床病史。
问卷涉及社会支持、家庭教育方式、自我形象和身体限制等主题，还使用了经过标准化的情感障碍和精神分裂症终身版定式临床访谈表（SADS-L），以及关于社会心理适应的自我报告问卷、青少年自我报告或成人自我报告。一位亲属完成了相同问卷的观察版本（儿童行为检查表（CBCL）或 ABCL（成人行为检查表））。
我们发现精神病理学的终身患病率为 21.8%，女性为 31.3%，男性为 14.5%，表明 CHD 患者的易感性略高。女性的社会心理适应也较差，表现出更多的躯体抱怨（u=260000；p=0.011）、焦虑/抑郁（u=984000；p=0.002）、攻击行为（u=920500；p=0.001）、注意力问题（u=1123500；p=0.027）、思维问题（u=1069500；p=0.010）、内化问题（u=869000；p=0.0）和外化问题（u=1163000；p=0.05）。患有严重 CHD（u=939000；p=0.03）和手术修复（u=719000；p=0.037）的患者社会心理适应较差。社会支持较差的患者表现出更多的退缩（u=557500；p=0.0）和社会问题（u=748500；p=0.023），学业成绩不理想的患者表现出更多的焦虑/抑郁（u=916000；p=0.02）和注意力问题（u=861500；p=0.007）。
具有良好社会支持和良好学业成绩的 CHD 男性具有更好的社会心理适应能力。
