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Covert fears, anxiety and depression in congenital heart disease

Published online by Cambridge University Press:  19 August 2008

S. Gupta*
Affiliation:
Alberta Children‘s Hospital, Alberta, and The University of Calgary, Calgary, Canada
R.M. Giuffre
Affiliation:
Alberta Children‘s Hospital, Alberta, and The University of Calgary, Calgary, Canada
S. Crawford
Affiliation:
Alberta Children‘s Hospital, Alberta, and The University of Calgary, Calgary, Canada
J. Waters
Affiliation:
Alberta Children‘s Hospital, Alberta, and The University of Calgary, Calgary, Canada
*
Dr. S. Gupta, Alberta Children‘s Hospital, 1820 Richmond Road SW, Calgary, Alberta T2T 5C7, Canada. Tel: (403)229-7970; Fax: (403)229-7086

Abstract

This study compared anxiety, fears, depression and behavioural problems as occurring in children with congenital heart disease, comparing them with samples of normal children. It further considered the influence of maternal anxiety, as well as analyzing a subgroup of children with cyanotic forms of congenital heart disease to determine if they were at higher risk than acyanotic children for the problems identified.

Method

We recruited 40 consecutive children with congenital heart disease without obvious psychoso-cial problems from the Cardiology clinic at the Alberta Children‘s Hospital. Of the 40 children, 39 families consented to have the children participate, of which 24 were cyanotic and 15 acyanotic. Children completed the revised versions of the Fear Survey Scale-Revised and the Child Manifest Anxiety Scale as well as the Child Depression Inventory. Mothers completed the Child Behaviour Checklist, and the State Trait Anxiety Scale.

Results

Children with congenital heart diseases demonstrated more medical fears, and more physiological anxiety, than the normative samples. More specifically, children with cyanotic forms of congenital heart disease demonstrated more fears of the unknown, physiological anxiety, depression, and delinquent behaviors than the acyanotic children with congenital heart disease. Mothers of the children with cyanotic forms of congenital heart disease scored higher on both the state and trait scales, with higher maternal anxiety correlating with higher anxiety, medical fears and behavioral problems in the child.

Conclusion

In a clinical setting, children with congenital heart diseases who do not present with psychological adjustment problems are still at risk for covert physiological anxiety, medical fears, depression and behavioral problems. The children with cyanotic malformations represent a subgroup at higher risk for these problems, which may be further exacerbated by increased maternal anxiety.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1998

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