The Prevalence and Predictors of Anxiety and Depression in Adolescents with Heart Disease

Objective To evaluate the prevalence and contributory factors of depression and anxiety in adolescents with heart disease. Study design A cohort of adolescents was recruited from an ambulatory cardiology clinic at a tertiary center and from such clinics run privately. Questionnaires included the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Life Orientation Test-Revised, and Sense of Coherence-13. Results A total of 119 adolescents aged 12-20 years were recruited. Most of the participants (90%) had congenital heart disease. Nearly all (98%) were in New York Heart Association Functional Classification class I. Approximately one-half of the participants had had previous surgeries and/or catheter interventions. Eleven patients (9%) were above the cut-off score for likely depression, and 32 (27%) had likely anxiety. A feeling of optimism was the most significant factor in reducing anxiety and depression, followed by good social support and a strong sense of coherence (multiple regressions, beta = -0.38, -0.2, -0.17, respectively). Conclusions Depression and anxiety were found to be common in a relatively well adolescent population with heart disease. None of those affected had been clinically assessed and appropriately treated by a mental health professional. Protective factors against depression and anxiety need be developed as well as appropriate assessment and intervention. (J Pediatr 2012;161:943-6).