Becoming a Teenager after Early Surgical Ventricular Septal Defect (VSD) Repair: Longitudinal Biopsychological Data on Mental Health and Maternal Involvement

Abstract

Beside somatic strains of congenital heart diseases (CHD), affected children often show developmental impairments in the long term. Ventricular septal defect (VSD) is the most common congenital heart defect and early surgical repair is associated with positive somatic outcomes. However, psychological adjustment is of lifelong relevance. We investigated 24 children with a surgically-corrected isolated VSD and their mothers from primary school (6–9 years) to adolescence (10–14 years) and compared them to controls. Both times, mothers reported child internalizing/externalizing problems, mothers and children rated child quality of life, and children performed neurodevelopmental tests. Adolescents also rated internalizing/externalizing problems themselves, and their hair cortisol levels were analyzed. Maternal anxiety and proactive parenting behavior were considered as moderators. Results revealed no group differences in child neurodevelopment (language, cognition), externalizing problems, and cortisol levels at any time. In reports from mothers, internalizing problems (depression, anxiety) were elevated in children with a VSD at both times—when mothers reported anxiety symptoms themselves. In adolescent reports, VSD patients’ quality of life was increased and internalizing problems were decreased—proactive parenting behavior went along with decreased symptoms in VSD-affected adolescents and with increased symptoms in controls. The findings pronounce the crucial role of parenting behavior and the influence of maternal anxieties on child mental health after surgical VSD repair and might highlight the need for parent-centered interventions.

Psychiatric co-morbidity in children and adolescents with CHDs: a systematic review

“…19,21,36 Of the 15 articles that had psychiatric symptoms as the outcome, 13 looked at attention deficit hyperactivity disorder 14,19,21,24–32,35 and 12 looked at emotional disorders. 14,19–21,24,25,29–31,33–35…”

“…We included 19 articles 13,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] from the first search and 1 extra from the second search 35 (Fig 1). Two articles were based on the same study.…”

“…Two articles were based on the same study. 14,35 Together, the included articles encompassed a total of 8035 unique patients with CHD. Fourteen articles reported on symptoms, four reported on psychiatric diagnoses, and two reported on both symptoms and diagnosis (Supplementary Material S2).…”

“…In the articles (n = 13) that investigated proxyreported symptoms, all but one article had parents as proxies. 14,[19][20][21]24,[26][27][28][29][30][31]35 The last articles had both teachers and parents as proxies. 32 The majority of the articles used control groups from another study 13,19,21,22,25,35 or healthy matched controls (sex, age) recruited from a local community sample.…”

“…14,[19][20][21]24,[26][27][28][29][30][31]35 The last articles had both teachers and parents as proxies. 32 The majority of the articles used control groups from another study 13,19,21,22,25,35 or healthy matched controls (sex, age) recruited from a local community sample. 24,[30][31][32][33][34] Four articles compared with normative data, 20,[26][27][28] one article included controls with one inpatient or emergency department record, 36 one article used a National Health Insurance Research Database, 23 one article used a sibling control, 29 and one article did not specify how the control group was recruited.…”