Dr. Adrienne H. Kovacs, chair of the scientific report writing committee and clinical psychologist who specializes in working with people with CHD. “It’s long overdue for us to go beyond awareness to take action and provide more resources and mental health professionals to people living with CHD.” An American Heart Association scientific statement is an expert analysis of current research and may provide future guidance. The Association’s 2011 Scientific Statement on a Related Topic addresses developmental delays and other neurodevelopmental outcomes in children with CHD. However, this is the first statement that summarizes the psychological and social challenges from childhood through adulthood and examines age-appropriate mental health interventions to improve quality of life. living. According to the new statement, children with more complex CHD conditions are five times more likely to receive an anxiety diagnosis in their lifetime than children without CHD. Despite evidence of emotional, social, and behavioral difficulties, only a small fraction of children with CHD are offered or participate in mental health assessment or treatment. For adults with CHD, the odds of experiencing a mood or anxiety disorder in their lifetime are about 50%, compared with about 30% in adults in the general population.
Statement summarizing the psychosocial impact of CHD in different life stages:
Newborns – Newborns can be exposed to scary or painful procedures, and they may be separated from caregivers and families for long periods of time for surgery or other hospitalisation. In response, infants with CHD may be overly sensitive to light and sound, have difficulty feeding and sleeping, or exhibit intense fear and distress, and they may experience developmental delays.
Childhood – Additional hospitalization and surgery may be required, so there are fewer opportunities for play or school, and they may also have developmental delays. In response, children with CHD may become socially withdrawn, experience symptoms of anxiety or depression, have difficulty in school, or appear aggressive or hyperactive.
Adolescence – Health concerns may arise at a time when adolescents are striving for independence, expanding social networks, and taking on greater responsibility for managing health care. their health as they transition from child care to adult care. In response, adolescents with CHD may have difficulty socializing, become angry, defiant, or frustrated, or worry about body image. They may also exhibit risky behaviors or not follow health recommendations.
Adolescence – New or worsening cardiac symptoms, repeat surgeries or other cardiac interventions during adulthood and CHD may have a negative financial impact, employment, insurance and family planning options. In response, adults with CHD may experience difficulties in interpersonal relationships, higher education, or employment. They may also have trouble taking care of their health needs and become anxious about death and dying.
“The psychological reaction to living with a congenital heart defect is completely understandable. The condition presents a multitude of challenges throughout life and can include unexpected news – such as a person realize they can no longer cope with the demands of their work or school, Kovacs says there are significant risks to pregnancy. “Many people with CHD have tremendous resilience in the face of adversity. these challenges. At the same time, we want to normalize psychological responses and increase the prevalence of mental health care to help people with CHD lead full and healthy lives.”
According to the statement, approaches to mental health care may include self-care strategies, such as relaxation techniques and online or hospital-based support groups; psychotherapy such as talk therapy for individuals, couples, families or groups; and drug therapy where the medical team can identify suitable, heart-safe medications to treat depression or anxiety.
The statement strongly supports the integration of mental health professionals within CHD’s intensive care teams. Integrated mental health care normalizes emotional responses to health challenges, reduces stigma, improves timely access to health challenges, and provides services coordinated care in a multidisciplinary healthcare team.
“The goal of this statement is to promote psychologically informed care to empower people with CHD and their families and provide emotional support,” said Mr Kovacs. “We want mental health assessment and support to be part of the comprehensive care for all people with CHD rather than a specialty service provided only in certain settings or in exceptional circumstances. .”
Additionally, the statement highlights priority areas for research to better understand and improve psychological outcomes for people with CHD, including:
how to best identify significant psychological distress;
factors that can contribute to psychological resilience and well-being;
get more information about the safety and effectiveness of psychotropic drugs across ages; and
personalized approaches to mental health interventions.