Faculty of Medicine, McGill University.
School of Physical and Occupational Therapy, Faculty of Medicine, McGill University.
J Pediatr Psychol. 2019 May 1;44(4):463-477. doi: 10.1093/jpepsy/jsy085.
Over the past 20 years, there has been a growing interest in the psychosocial outcomes of children and adolescents born with a congenital heart defect (CHD). This systematic review and meta-analysis aims to appraise and synthesize current literature on the psychosocial outcomes of children and adolescents with severe CHD.
A search of studies examining psychosocial outcomes in children and adolescents with severe CHD was performed. Meta-analyses were used to calculate the prevalence of psychosocial impairments and the standardized mean differences between cases and controls. Results that were not included in the meta-analysis were collated using descriptive statistics.
A total of 16 studies were included in this review, and results were summarized according to three domains: behavior, social cognition, and self-esteem. Results from a meta-analysis identified that 25% of children and adolescents with CHD presented behavioral problems. Children and adolescents with CHD had more problematic behavior than healthy peers (standardized mean difference; g = 0.71). Young people with CHD had significantly more difficulties inferring on the mental states of others (standardized mean difference; g = 0.72). In contrast, identifying the emotions of others and self-esteem was not statistically different from healthy controls.
This review and meta-analysis provides evidence to support the presence of psychosocial difficulties in children and adolescents born with a severe CHD giving grounds for the systematic assessment of behavior and social cognition during their clinical follow-up.
在过去的 20 年中，人们对患有先天性心脏病 (CHD) 的儿童和青少年的心理社会结局越来越感兴趣。本系统评价和荟萃分析旨在评估和综合目前关于严重 CHD 儿童和青少年心理社会结局的文献。
对研究严重 CHD 儿童和青少年心理社会结局的研究进行了检索。使用荟萃分析计算心理社会障碍的患病率以及病例组与对照组之间的标准化均数差异。未纳入荟萃分析的结果使用描述性统计进行汇总。
本综述共纳入 16 项研究，根据三个领域进行总结：行为、社会认知和自尊。荟萃分析的结果表明，25%的 CHD 患儿存在行为问题。CHD 患儿的行为问题比健康同龄人更为严重（标准化均数差异；g=0.71）。CHD 青少年在推断他人心理状态方面存在明显困难（标准化均数差异；g=0.72）。相比之下，识别他人的情绪和自尊与健康对照组没有统计学差异。
本综述和荟萃分析提供了证据支持严重 CHD 患儿存在心理社会困难，这为在临床随访中对行为和社会认知进行系统评估提供了依据。
