Disclosures: The authors report no relevant financial disclosures.
January 05, 2021
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Children with congenital heart disease likelier to have anxiety, depression, ADHD

Disclosures: The authors report no relevant financial disclosures.
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Children with congenital heart disease are significantly more likely to have anxiety, depression or ADHD, according to data from a Texas hospital.

Vincent J. Gonzalez, MD, MS, a pediatric cardiology fellow at Baylor College of Medicine, and colleagues analyzed the medical records of patients aged 4 to 17 years with at least one hospitalization or ED visit from 2011 to 2016 at Texas Children’s Hospital.

Children diagnosed with anxiety, depression and/or ADHD

Among 118,785 patients, 1,164 (approximately 1%) had congenital heart disease (CHD). Most patients with CHD had simple (47.7%) or complex nonsingle ventricle (46.9%) lesions, Gonzalez and colleagues reported.

Of the 1,164 patients with CHD, 18.2% (n = 212) had a diagnosis or medication for anxiety or depression compared with 5.2% (n = 6,088) of the remaining patients, data showed. Children with CHD also had a higher prevalence of ADHD (5.1%) compared with their peers (2.1%).

According to the study, children in all age groups with CHD had significantly higher odds of anxiety and/or depression or ADHD. Children aged 4 to 9 years with simple CHD were roughly five times more likely (OR = 5.23; 95% CI, 3.87-7.07) and those with complex CHD were roughly 7 times more likely (OR = 7.46; 95% CI, 3.7-15.07) to receive a diagnosis or treatment for anxiety and/or depression, the researchers reported.

Vincent J. Gonzalez

“We feel that our research produces novel findings in that preadolescent children with any type of congenital heart disease appear to have anxiety and/or depression and ADHD at significantly higher rates than those without CHD,” Gonzalez told Healio. “It was previously suspected that adolescents and adults with CHD had higher rates of these disorders; however, this is the first study to suggest that younger patients with CHD may as well.”

The authors noted that minority and/or uninsured youth were significantly less likely to be diagnosed or treated for anxiety, depression and/or ADHD.

Non-Hispanic Black individuals were 47% less likely to be diagnosed or treated for anxiety and/or depression, whereas Hispanic youth were 52% less likely and Asian youth were 33% less likely, they reported. Non-Hispanic Black youth were 45% less likely to be diagnosed or treated for ADHD, whereas Black individuals were 78% less likely, and Asian youth were 86% less likely. The authors noted that these odds held, even after controlling for insurance type.

“Our findings indicate that providers caring for all patients with any type of CHD should consider screening for symptoms of anxiety, depression or ADHD earlier in childhood,” Gonzalez said. “Further, parents of those with CHD may consider having discussions with their children and pediatricians earlier in childhood to screen for such conditions.”