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Covert fears, anxiety and depression in congenital heart disease

Published online by Cambridge University Press:  19 August 2008

S. Gupta ,
R.M. Giuffre ,
S. Crawford  and
J. Waters
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
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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.

Keywords

Anxietyfearsdepression
Type
Original Articles
Information
Cardiology in the Young , Volume 8 , Issue 4 , October 1998 , pp. 491 - 499
Copyright
Copyright © Cambridge University Press 1998

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References

1.Leek, I. Structural birth defects. In: Pless, IB (ed). The epidemiology of childhood disorders. Oxford University Press, New York, 1994.Google Scholar
2.Nolan, T, Pless, B.Emotional correlates and consequences of birth defects. J Pediatrics 1986; 109: 201–216.CrossRefGoogle ScholarPubMed
3.Eksi, A, Molzan, J, Savasir, I, Guler, N.Psychological adjustment of children with mild and moderately severe asthma. Eur Child Adoles Psychiatry 1995; 4: 77–84.CrossRefGoogle ScholarPubMed
4.Inhelder, B, Sinclair, H, Bovet, M.Learning and the development of cognition. Harvard University Press, Cambridge, MA., 1974. p.3.Google Scholar
5.Lerner, RH.Concepts and theories of human development: The nature and nurture of intelligence. Addison Welsey, Reading, MA., 1976.Google Scholar
6.Myers-Vando, R, Steward, MS, Folkins, CH, Hines, P.The effects of congenital heart disease on cognitive development, illness causality concepts and vulnerability. Am J Orthopsychiat 1979; 49: 617–625.CrossRefGoogle ScholarPubMed
7.Kramer, HH, Awiszus, D, Sterzel, U, van Halteren, A, Claben, R.Development of personality and intelligence in children with congenital heart disease. J Child Psychol Psychiat 1989; 30: 299–308.CrossRefGoogle ScholarPubMed
8.Bjornstad, PThe impact of severe congenital heart disease on physical and psychosocial functioning in adolescents. Cardiol Young 1995; 5: 56–62.CrossRefGoogle Scholar
9.Utens, EMWJ, Verhulst, FC, Meijboom, FJ et al. Behavioural and emotional problems in children and adolescents with congenital heart disease. Psycho Med 1993; 23: 415–424.CrossRefGoogle ScholarPubMed
10.Gustafsson, PA, Kjellman, N-IM, Ludvigsson, J, Cederblad, M.Asthma and family interaction. Arch Dis Child 1987; 62: 258–263.CrossRefGoogle ScholarPubMed
11.Wallander, JL, Varni, JW, Babani, L, Banis, HT, Wilcox, KT.Family resources as resistance factors for psychological malad-justment in chronically ill and handicapped children. J Pediatr Psychol 1989; 14: 157–173.CrossRefGoogle ScholarPubMed
12.Linde, LM.Psychiatric aspects of congenital heart disease. Psychiatric Clinics of North America 1982; 5: 399–405.CrossRefGoogle ScholarPubMed
13.Warnes, CA, Sommerville, JS.Tricuspid atresia in adolescents and adults; current states and late complication. British Heart Journal 1986; 56: 535–543.CrossRefGoogle Scholar
14.Ollendick, TH.The Fear Survey Schedule for Children — Revised. Unpublished manuscript, Indiana State University, Terre Haute, Indiana, 1978.Google Scholar
15.Last, CG, Francis, G, Strauss, CC.Assessing fears in anxiety-disordered children with the Revised Fear Survey Schedule for Children (FSSC-R). J Clin Child Psychol 1989; 18: 137–141.CrossRefGoogle Scholar
16.Ollendick, TH.Reliability and validity of the Revised Fear Survey Schedule for Children (FSSC-R). Behav Res Therapy 1983; 21: 685–692.CrossRefGoogle Scholar
17.Reynolds, CR, Richmond, BO.Revised Children‘s Manifest Anxiety Scale. Western Psychological Services, Los Angeles, 1978.Google Scholar
18.Reynolds, CR, Paget, KD.National normative and reliability data for the revised Children‘s Manifest Anxiety Scale. School Psychol Rev 1983; 12: 324–336.CrossRefGoogle Scholar
19.King, N, Gullone, E, Ollendick, T.Fears in children and adolescents with chronic medical conditions. J Clin Child Psychol 1990; 19: 173–177.CrossRefGoogle Scholar
20.Kovacks, M.Children‘s Depression Inventory. Multi-Health Systems, Inc., Toronto, 1992.Google Scholar
21.Curry, JF, Craighead, WE.Attributional style and self-reported depression among adolescent inpatients. Child and Family Behavioural Therapy 1990; 12: 89–93.Google Scholar
22.Eason, LJ, Finch, AJ Jr, Brasted, W, Saylor, CF.The assessment of depression and anxiety in hospitalized pediattic patients. Child Psychiatry and Human Development 1985; 16: 57–64.CrossRefGoogle ScholarPubMed
23.Achenbach, TM.Manual for the Child Behaviour Checklist/4–18 and 1991 profile. University of Vermont, Burlington, VT., 1991.Google Scholar
24.Achenbach, TM, Edelbrock, C.Manual for the Child Behaviour Checklist and Revised Child Behaviour Profile. University of Vermont, Burlington, VT., 1983.Google Scholar
25.Spielberger, CD, Gorsuch, RL, Lushen, R, Vagg, PR, Jacobs, GA.State-Trait Anxiety Inventory (Form Y). Consulting Psychologists Press, Inc., Palo Alto, CA., 1983.Google Scholar
26.Butz, A, Alexander, C.Anxiety in children with asthma. J Asthma 1993; 30: 199–209.CrossRefGoogle ScholarPubMed
27.Blishen, BR, Carroll, WK, Moore, C.The 1981 socioeconomic index for occupations in Canada. Can Rev Sociol Anthropol 1987; 24: 465–488.CrossRefGoogle Scholar
28.Hambley, J, Brazil, K, Furrow, D, Chaa, YY.Demographic and psychosocial characteristics of asthmatic children in a Canadian rehabilitation setting. J Asthma 1989; 26: 167–175.CrossRefGoogle Scholar
29.DeMaso, DR, Campis, LJ et al. The Impact of Maternal Perceptions and Medical Severity on the Adjustment of Childten with Congenital Heart Disease. J Pediatt Psychol 1991; 16: 137–149.Google ScholarPubMed
30.Linde, LM, Rasof, B, Dunn, OJ, Rabb, E.Attitudinal factors in congenital heart disease. Pediatrics 1966; 38: 92–101.CrossRefGoogle ScholarPubMed
31.Linde, LM.Physical and emotional aspects of congenital heart disease in children. Am J Cardiol 1971; 27: 712–713.CrossRefGoogle ScholarPubMed
32.Garson, SL, Baer, P. Psychological aspects of heart disease in Childhood. In: Garson, A, Bricker, jj, McNarmara, DG (eds). Science and Practice of Pediatric Cardiology. Lea & Febiger, Philadelphia, 1990.Google Scholar
33.Spuckland, I. Mental health and psychosocial functioning in adolescents with congenital heart disease. A comparison between adolescents born with severe heart defect and atrial septal defect. Acta Paediatr 1993; 82: 71–76.Google Scholar
34.Garson, A, Williams, RB, Reckless, L: Long-term follow-up with patients with tetralogy of Fallot. Physical health and psy- chopathology. J Pediatr 1974; 85: 429–433.Google Scholar