Ferguson Meaghan, Kovacs Adrienne H
Graduate Program in Psychology, York University, Toronto, Ontario, Canada.
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Congenit Heart Dis. 2016 Sep;11(5):444-451. doi: 10.1111/chd.12331. Epub 2016 Feb 26.
North American adults with congenital heart disease (CHD) are at increased risk of mood and anxiety disorders, although there are no published data on psychological treatment. In order to provide guidance to adult CHD (ACHD) programs considering the integration of psychological care, the aim of this study was to provide a comprehensive description of a specialized ACHD psychological service.
At a large tertiary hospital, a retrospective review of 100 ACHD clinic patient psychology files was performed. The following data were abstracted: sociodemographic and medical background, presenting psychological concerns, and the course and outcome of psychological intervention.
Of 100 patients, the mean age was 33 ± 11 years and 51% were female. Prevalent psychological concerns were generalized anxiety (82%), health-/heart-related anxiety (71%), depressed mood (60%), and difficulty coping with a medical condition (49%); 65% of patients met diagnostic criteria for a mood or anxiety disorder. Following assessment, individual psychotherapy was offered to 87 patients, of whom 75 opted to proceed with treatment. The median number of psychotherapy sessions was 8 and treatment most frequently included cognitive therapy (92%), relaxation skills training (57%), and communication skills training (46%). Of 64 patients for whom a course of psychotherapy had ended at the time of data abstraction, 54 (88%) had reduced or absent psychological distress.
Reduced psychological distress can be achieved among adults with CHD who receive targeted psychological intervention. Consistent with the emerging field of behavioral cardiology, other ACHD programs as well as general cardiovascular programs are encouraged to integrate cardiac psychology services in order to provide comprehensive patient care.
北美先天性心脏病（CHD）成人患者患情绪和焦虑症的风险增加，尽管尚无关于心理治疗的公开数据。为了给考虑整合心理护理的成人先天性心脏病（ACHD）项目提供指导，本研究的目的是全面描述一项专门的ACHD心理服务。
在一家大型三级医院，对100份ACHD门诊患者心理档案进行了回顾性研究。提取了以下数据：社会人口统计学和医学背景、呈现的心理问题以及心理干预的过程和结果。
100名患者的平均年龄为33±11岁，51%为女性。常见的心理问题包括广泛性焦虑（82%）、健康/心脏相关焦虑（71%）、情绪低落（60%）以及应对医疗状况困难（49%）；65%的患者符合情绪或焦虑症的诊断标准。评估后，87名患者接受了个体心理治疗，其中75名选择继续治疗。心理治疗的中位数疗程为8次，治疗最常包括认知疗法（92%）、放松技能训练（57%）和沟通技能训练（46%）。在数据提取时，64名已完成一个心理治疗疗程的患者中，54名（88%）心理困扰减轻或消失。
接受针对性心理干预的CHD成人患者心理困扰可减轻。与行为心脏病学这一新兴领域一致，鼓励其他ACHD项目以及一般心血管项目整合心脏心理服务，以提供全面的患者护理。
