Gleason Lacey P, Deng Lisa X, Khan Abigail M, Drajpuch David, Fuller Stephanie, Ludmir Jonathan, Mascio Christopher E, Partington Sara L, Tobin Lynda, Kim Yuli Y, Kovacs Adrienne H
Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.
Cardiol Young. 2019 Feb;29(2):185-189. doi: 10.1017/S1047951118002068. Epub 2019 Jan 30.
Adults with congenital heart disease face psychological challenges although an understanding of depression vs. anxiety symptoms is unclear. We analyzed the prevalence of elevated symptoms of anxiety and depression and explored associations with demographic and medical factors as well as quality of life.
Adults with congenital heart disease enrolled from an outpatient clinic completed the Hospital Anxiety and Depression Scale and two measures of quality of life: the Linear Analogue Scale and the Satisfaction with Life Scale. Medical data were obtained by chart review.
Of 130 patients (median age = 32 years; 55% female), 55 (42%) had elevated anxiety symptoms and 16 (12%) had elevated depression symptoms on subscales of the Hospital Anxiety and Depression Scale. Most patients with elevated depression symptoms also had elevated anxiety symptoms (15/16; 94%). Of 56 patients with at least one elevated subscale, 37 (66%) were not receiving mental health treatment. Compared to patients with 0 or 1 elevated subscales, patients with elevations in both (n=15) were less likely to be studying or working (47% vs. 81%; p=0.016) and reported lower scores on the Linear Analogue Scale (60 vs. 81, p<0.001) and the Satisfaction with Life Scale (14 vs. 28, p<0.001).
Among adults with congenital heart disease, elevated anxiety symptoms are common and typically accompany elevated depressive symptoms. The combination is associated with unemployment and lower quality of life. Improved strategies to provide psychosocial care and support appropriate engagement in employment are required.
患有先天性心脏病的成年人面临心理挑战，尽管对抑郁与焦虑症状的了解尚不清楚。我们分析了焦虑和抑郁症状加重的患病率，并探讨了其与人口统计学和医学因素以及生活质量的关联。
从门诊招募的患有先天性心脏病的成年人完成了医院焦虑抑郁量表以及两项生活质量测量指标：线性模拟量表和生活满意度量表。通过查阅病历获取医学数据。
在130名患者（中位年龄 = 32岁；55%为女性）中，55名（42%）在医院焦虑抑郁量表的子量表上有焦虑症状加重，16名（12%）有抑郁症状加重。大多数抑郁症状加重的患者也有焦虑症状加重（15/16；94%）。在56名至少有一个子量表升高的患者中，37名（66%）未接受心理健康治疗。与子量表升高0个或1个的患者相比，两个子量表都升高的患者（n = 15）学习或工作的可能性较小（47%对81%；p = 0.016），并且在线性模拟量表上的得分较低（60对81，p<0.001）以及在生活满意度量表上的得分较低（14对28，p<0.001）。
在患有先天性心脏病的成年人中，焦虑症状加重很常见，并且通常伴有抑郁症状加重。这种组合与失业和较低的生活质量相关。需要改进策略以提供心理社会护理并支持适当的就业参与。
