Abstract
BACKGROUND
Adults with congenital heart disease (CHD) may experience substantial psychological distress. This study evaluated whether a documented history of anxiety disorders is associated with a distinct psychosocial profile in adults with CHD.
METHODS
In this cross-sectional study, 45 adults with CHD were included: 21 with a documented history of anxiety disorders and 24 without. Psychosocial assessment included the EuroQol-5D-3L (EQ-5D-3L), Rosenberg Self-Esteem Scale (RSES), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory-II (BDI-II). Associations between psychosocial measures and documented anxiety history were assessed using multivariable logistic regression adjusted for sex, NYHA functional class, and CHD complexity. Moderate depression was additionally assessed using univariable logistic regression.
RESULTS
Mean age was 35 ± 9 years in participants with a documented history of anxiety disorders and 31 ± 11 years in those without (P = 0.230); males accounted for 33% and 62%, respectively (P = 0.052). NYHA functional class II-IV was more frequent among participants with a documented history of anxiety disorders (67% vs. 25%; P = 0.018). Compared with those without a documented anxiety history, participants with anxiety history reported greater limitations in usual activities (P = 0.021), higher anxiety/depression scores on the EQ-5D-3L (P = 0.023), poorer self-rated health (P = 0.038), higher trait anxiety (31.2 ± 5.8 vs. 26.5 ± 5.2; P = 0.008), and greater depressive symptom severity (BDI-II median 19 vs. 3; P = 0.001). Self-esteem was also higher (RSES median 27 vs. 25; P = 0.006). After adjustment, BDI-II scores were positively associated with a documented history of anxiety disorders (OR 1.14, 95% CI 1.05-1.28; P = 0.011), while EQ-5D VAS scores were inversely associated (OR 0.64, 95% CI 0.38-0.97; P = 0.048). STAI-State, STAI-Trait, and RSES scores were not significantly associated with anxiety history. None of the variables assessed in the univariable analysis was significantly associated with moderate depression.
CONCLUSIONS
In adults with CHD, a documented history of anxiety disorders was associated with greater depressive symptom severity and poorer self-rated health after adjustment for relevant clinical factors.