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European Heart Journal 2004 25(18):1605-1613; doi:10.1016/j.ehj.2004.06.025
Copyright © 2004 by the European Society of Cardiology.
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Clinical research

Medical predictors for psychopathology in adults with operated congenital heart disease

E.H.M. van Rijena,*, E.M.W.J. Utensa, J.W. Roos-Hesselinkb, F.J. Meijboomb, R.T. van Domburgb, J.R.T.C. Roelandtb, A.J.J.C. Bogersc and F.C. Verhulsta

a The department of Child and Adolescent Psychiatry, Erasmus MC — Sophia Children's Hospital, The Netherlands
b The department of Cardiology Thoraxcenter, Erasmus MC, The Netherlands
c The department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, The Netherlands

Received September 11, 2003; revised April 21, 2004; accepted June 10, 2004 * Corresponding author. EHM van Rijen, Tel.: +31-10-4089755; fax: +31-10-408-9009 (E-mail: vanrijen{at}fsw.eur.nl).

Aims To test the predictive value of medical variables, covering the complete medical course from birth until the present, for long-term behavioural and emotional problems in adulthood, in patients operated for congenital heart disease in childhood.

Methods and results This study concerns the second psychological and medical follow-up of a cohort of patients operated for congenital heart disease (n=362; age 20–46 years). Behavioural and emotional problems were assessed with the Young Adult Self-Report and the Young Adult Behavior Checklist. Medical prediction variables were derived from medical examination and file search. Being female, having low exercise capacity and restrictions imposed by physicians are significant predictors for behavioural and emotional problems as reported by patients themselves. Regarding the scar, personal experiences of patients form a better predictor for later problems than judgement of aesthetical aspects by physicians. Early hospitalisations with reoperations are predictive for behavioural and emotional problems as reported by other informants. The cardiac diagnoses of ventricular septal defect and transposition of the great arteries are associated with higher levels of behavioural and emotional problems.

Conclusion Recent experiences concerning the scar, physical condition and imposed restrictions are the strongest predictors for behavioural and emotional problems as reported by patients themselves.


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