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Psychological symptoms in patients after surgery forcongenital cardiac disease

Published online by Cambridge University Press:  20 November 2006

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

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.

Type
Original Article
Copyright
© 2006 Cambridge University Press

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