Abstract 18614: Long-term Psychosocial Outcomes of Congenital Heart Disease: Neurocognitive Performance, Quality of Life, Psychosocial Adjustment and Psychiatric Morbidity of Adolescents and Young Adults Surviving Their Disease
Objectives: to study neurocognitive performance (NP) of CHD patients and to determine whether is related to parameters of fetal development registered at birth, head circumference (HC), weight (W) and length (L) and neonatal parameters (APGAR 1, 5); to study their quality of life (QOL), psychiatric morbidity (PM), psychosocial adjustment (PSA) and traits of personality (TP).
Methods: 266 CHD patients, 148 male, aged from 12 to 30 years (mean= 18.00 ± 3.22), 103 cyanotic, and 119 healthy controls (56 males, mean=18.41±3.20) participated. Clinical data were collected. Neuropsychological assessment included Wechsler’s Digit Test (direct and reverse) and Symbol Search, Rey’s Complex Figure, BADS’s Key Searching Test, Color-Word Stroop Test, Trail Making Test (A, B) and Logical Memory Task. Participants were interviewed on social support, family educational style, self-image, physical limitations, completed a psychiatric interview (SADS-L) and self-report questionnaires on QOL (WHOQOL-BREF), PSA (YSR and ASR) and TP (NEOPI-R). HC, W and L and APGAR were collected.
Results: CHD patients had a significantly worse NP than healthy controls in all tests, and the cyanotic worse than the acyanotic patients (but not significantly). Several correlations were apparent between fetal parameters (HC, W and L) and neuropsychological abilities in CHD. However, low weight at birth, cyanosis and male gender are the main predictors of bad NP later on in CHD patients (R=0.414; R2=0.171; F=5.787; p=0.001; β=1.654; t=2.858; p=0.005; β=1.881; t=2.377; p=0.020; b=1.624; t=2.062; p=0.042). We found a 15.3% lifetime prevalence of psychopathology (18.5% in females). Comparing to normal population, our patients have better QOL in environmental (t=6.907; p=0.000), social relationships (t=5.102; p=0.000) and general dimensions (t=2.558; p=0.011). Complex CHD reported worse QOL in physical dimension (U=3576.500; p=0.001) than those with moderate/mild forms of disease; Female patients showed worse PSA, with more withdrawal, anxiety/depression and internalization.
Conclusion: CHD patients have worse NP than controls; low weight at birth, male gender and the presence of cyanosis predict bad NP in CHD patients; patients seem to be more prone to PM, worse PSA and SP.
Author Disclosures: M.G. Areias: None. S. Melo: None. J. Lopes: None. F. Rodrigues: None. A. Nascimento: None. D. Cerqueira: None. L. Gomes: None. A. Estrela: None. J. Miranda: None. F. Vilacova: None. C. Moura: None. J. Soares: None. B. Peixoto: None. J. Quintas: None. J. Areias: None.
- © 2014 by American Heart Association, Inc.