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Psychological symptoms in patients after surgery forcongenital cardiac disease

Published online by Cambridge University Press:  20 November 2006

Siegfried Geyer ,
Kambiz Norozi ,
Monika Zoege ,
Almut Kempa ,
Reiner Buchhorn  and
Armin Wessel
Siegfried Geyer
Affiliation:
Medical Sociology Unit, Hannover Medical School, Hannover, Germany
Kambiz Norozi
Affiliation:
Department of Paediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany
Monika Zoege
Affiliation:
Medical Sociology Unit, Hannover Medical School, Hannover, Germany
Almut Kempa
Affiliation:
Medical Sociology Unit, Hannover Medical School, Hannover, Germany
Reiner Buchhorn
Affiliation:
Department of Paediatric and Adolescent Medicine, Caritas Hospital, Bad Mergentheim, Germany
Armin Wessel
Affiliation:
Department of Paediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany
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Abstract

Aims: We studied a population of patients with surgically corrected congenital cardiac disease to determine whether limitations in activity, impaired cardiac performance, and perception of body image have effects on psychological symptoms. Methods: We undertook medical examinations, and carried out standardized interviews, in 361 patients aged between 14 and 45 years with surgically corrected congenital cardiac disease. From this data, findings from 343 patients were suitable for analysis. Subjectively reported limitations in activity were classified according to the system proposed by the New York Heart Association, while cardiopulmonary capacity was used as the indicator of cardiac performance. The Brief Symptom Inventory was used for assessing psychological symptoms, such as somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The Body Image Questionnaire was used to depict attitudes towards body image, which is assessed on the two subscales of rejection of the body and vitality. Multivariate regression analyses were conducted separately for females and males, taking into account age and socio-economic position. Results: Impairments of everyday activities had only a few substantial associations with psychological symptoms. No significant effects of cardiac functional capacity as a standardized physiological measure emerged. Psychological symptoms were strongly influenced by perceptions of body image, particularly if they rejected it, this holding particularly for males. There were no gender differences in terms of psychological symptoms. Conclusions: Limitations of activity, and impaired cardiac performance, have only minor effects on psychological symptoms in patients with surgically corrected congenital cardiac disease. The perception of body image was the strongest predictor, especially if patients rejected their body as a result of disfigurement or perceived deficiency.

Keywords

Body imagegenderlimitations of activitycardiac performance
Type
Original Article
Information
Cardiology in the Young , Volume 16 , Issue 6 , December 2006 , pp. 540 - 548
Copyright
© 2006 Cambridge University Press

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References

Botto LD, Correa A. Decreasing the burden of congenital heart anomalies: an epidemiologic evaluation of risk factors and survival. Prog Pediatr Cardiol 2003; 18: 111–121.Google Scholar
Nieminen H, Sairanen H, Tikanoja T, et al. Long-term results of pediatric cardiac surgery in Finland: Education, employment, marital status, and parenthood. Pediatrics 2003; 112: 1345–1350.Google Scholar
Moons P, De Bleser L, Budts W, et al. Health status, functional abilities, and quality of life after mustard or senning operation. Ann Thorac Surg 2004; 77: 1359–1365.Google Scholar
Kamphuis RP, Ottenkamp J, Vliegen HW, et al. Health related quality of life and health status in adult survivors with previously operated complex congenital heart disease. Heart 2002; 7: 356–362.Google Scholar
Utens EM, Verhulst FC, Erdman RA, et al. Psychosocial functioning of young adults after surgical correction for congenital heart disease in childhood: a follow-up study. J Psychosom Res 1994; 38: 745–758.Google Scholar
Brandhagen DJ, Feldt RH, Williams DE. Long-term psychologic implications of congenital heart disease: a 25-year follow-up. Mayo Clinic Proceedings 1991; 66: 474–479.Google Scholar
Van Rijen EHM, Utens EM, Roos-Hesselink JWMFJ, et al. Medical predictors for psychopathology in adults with congenital heart disease. Eur Heart J 2004; 25: 1605–1613.Google Scholar
Van Rijen EHM, Utens EM, Roos-Hesselink JW, et al. Longitudinal development of psychopathology in an adult congenital heart disease cohort. Int J Cardiol 2005; 99: 315–323.Google Scholar
Bromberg JI, Beasley PJ, D'Angelo EJ, Landzberg M, DeMaso DR. Depression and anxiety in adults with congenital heart disease. Heart Lung 2003; 32: 105–175.Google Scholar
Derogatis LR. SCL-90-R, administration, scoring & procedures manual-II for the R(evised) version and other instruments of the Psychopathology Rating Scale Series. Clinical Psychometric Research Inc., Townson, 1992.
Derogatis LR, Melisaratos N. The Brief Symptom Inventory: An introductory report. Psychol Med 1983; 13: 595–605.Google Scholar
Masi G, Brovedani P. Adolescents with congenital heart disease: psychopathological implications. Adolescence 1999; 34: 185–191.Google Scholar
Gantt LT. Growing up heartsick: The experiences of young women with congenital heart disease. Health Care of Women International 1992; 13: 241–248.Google Scholar
Ladwig KH, Marten-Mittag B, Formanek B, Dammann G. Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol 2000; 16: 511–518.Google Scholar
Daliento L, Mapelli D, Scarso P, et al. Health related quality of life in adults with repaired tetralogy of Fallot: psychosocial and cognitive outcomes. Heart 2005; 91: 213–218.Google Scholar
Van Rijen EHM, Utens EM, Roos-Hesselink JW, et al. Psychosocial functioning of the adult with congenital heart disease: a 20–33 years follow-up. Eur Heart J 2003; 24: 673–683.Google Scholar
Kovacs AH, Sears SF, Saidi AS. Biopsychosocial experiences of adults with congenital heart disease: Review of the literature. Am Heart J 2005; 150: 193–201.Google Scholar
Arber S, Lahelma E. Inequalities in women's and men's ill-health: Britain and Finland compared. Soc Sci Med 1993; 37: 1055–1068.Google Scholar
Lahelma E, Martikainen P, Rahkonen O, Silventoinen K. Gender differences in illhealth in Finland: patterns, magnitude and change. Soc Sci Med 2001; 48: 7–19.Google Scholar
Franke GH. Brief Symptom Inventory von L. R. Derogatis (Kurzform der SCL-90-R) – Deutsche Version. Beltz Test, Göttingen, 2000.
Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnoses of diseases in the heart and blood vessels. New York Heart Association, New York, 1953.
Meyer T, Scharhag J, Kindermann W. Peak oxygen uptake. Myth and truth about an internationally accepted reference value. Z Kardiol 2005; 94: 255–264.Google Scholar
Mancini D, LeJemtel T, Aaronson K. Peak VO2. A simple yet enduring standard. Circulation 2000; 101: 1080–1082.Google Scholar
Pothoff G, Winter U, Wassermann K. Ergospirometric studies of normal probands for an unsteady state increment test program. Z Kardiol 1994; 83: 116–123.Google Scholar
Loewe B, Clement U. Der Fragebogen zum Körperbild (FKB-20). Literaturüberblick, Beschreibung und Prüfung eines Meβinstruments. [The body image questionnaire, FKB-20: A review of the literature, description and validation of a new instrument]. Diagnostica 1996; 42: 352–376.Google Scholar
Mielck A. Soziale Ungleichheit und Gesundheit. Huber, Bern, 2000.
Ganzeboom HBG, Treiman DJ. Internationally comparable measures of occupational status for the 1988 international standard classification of occupations. Soc Sci Res 1996; 25: 201–239.Google Scholar
Stata Corp. Stata Statistical Software: Release 8.0. College Station, TX, 2004.