Psychological interventions for depression in adolescent and adult congenital heart disease

Lane, Deirdre A.; Millane, T; Lip, Gregory Y.H.

doi:10.1002/14651858.cd004372.pub2

Cited by 29 publications

(8 citation statements)

References 47 publications

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“…Despite this relatively large number of studies, none considered a sample or subgroup in which a comorbid LTC was present. Similarly, systematic reviews of non-pharmacological treatments for depression in CYP with traumatic brain injury 71 and congenital heart disease 72 found no relevant randomised controlled trials (RCTs) in CYP.…”

Section: Previous Systematic Reviewsmentioning

confidence: 99%

Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses

Moore

Nunns

Shaw

et al. 2019

Health Technol Assess

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Background Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them. Objectives To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2). Data sources For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted. Review methods The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen’s d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography. An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. Results Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive–behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention–LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research. Limitations Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis. Conclusions There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project. Study registration This study is registered as PROSPERO CRD42011001716. Funding The National Institute for Health Research (NIHR) Health Technology Assessment programme and the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.

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Section: Previous Systematic Reviewsmentioning

confidence: 99%

Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses

Moore

Nunns

Shaw

et al. 2019

Health Technol Assess

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“…However, little has been determined about effective psychological interventions for patients with CHD6,38). Although use of tricyclic antidepressants and selective serotonin receptor inhibitors for the treatment of secondary depression with diverse causes has been widely accepted39), specialized services devoted to individual patients' conditions may be preferable, because they could provide multidisciplinary and comprehensive patient care40). It is important to recognize that treating psychosocial disorders, including depression and anxiety, in CHD patients may require specialized multidisciplinary management to alleviate symptoms from diverse psychosocial dysfunction and to improve QoL40).…”

Section: Solutions To Improve Psychosocial Function and Qol Of Adolesmentioning

confidence: 99%

“…Although use of tricyclic antidepressants and selective serotonin receptor inhibitors for the treatment of secondary depression with diverse causes has been widely accepted39), specialized services devoted to individual patients' conditions may be preferable, because they could provide multidisciplinary and comprehensive patient care40). It is important to recognize that treating psychosocial disorders, including depression and anxiety, in CHD patients may require specialized multidisciplinary management to alleviate symptoms from diverse psychosocial dysfunction and to improve QoL40). Therefore, the primary health care provider for CHD patients is encouraged to cooperate actively with psychiatrists, psychologists, social workers, chaplains, and family members to improve psychosocial functioning.…”

Section: Solutions To Improve Psychosocial Function and Qol Of Adolesmentioning

confidence: 99%

Psychosocial adjustment and quality of life of adolescents and adults with congenital heart disease

Kim

2014

Korean J Pediatr

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The incidence of people living with congenital heart disease (CHD) has been increasing every year owing to remarkable advances in surgical and catheter intervention techniques and devices, and improved knowledge of critical care for patients with CHD. However, these patients continue to face physical, psychosocial, and environmental challenges, and a number of studies have shown higher rates of depression and anxiety disorders than the general population. To improve psychosocial functioning and quality of life for adults with CHD, health care providers are recommended to inform CHD patients of an accurate diagnosis, and overall treatment process, beginning in adolescence to facilitate a smooth transition from adolescence to adulthood. Active cooperation with psychiatrists, psychologists, social workers, chaplains, and family members is highly recommended to help CHD patients feel normal and optimistic and to promote good social interactions, close family relationships, and a strong sense of coherence.

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“…Examples include Quest for the Code (an interactive and educational game for children with asthma; http://asthma.starlight.org/) and Re‐Mission 2 (an interactive and educational game for children with cancer; http://www.re-mission2.org/). Psychological issues, especially anxiety and depression, are usually addressed using standard psychological treatments that have not expressly been tested in this population …”

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confidence: 99%

Game for health: How eHealth approaches might address the psychological needs of children and young people with long‐term physical conditions

Thabrew

Stasiak

Garcia-Hoyos

et al. 2016

J Paediatrics Child Health

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eHealth interventions are currently being used in a limited manner by children and young people with long-term physical conditions and their families. Despite some concern expressed mainly by clinicians, there is overall support from all groups for the future development of eHealth interventions to address psychological issues for this audience, particularly anxiety. Relatable content, technological appeal and ease of access/referral to such interventions are likely to improve the uptake of these relatively new interventions.

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Psychological interventions for depression in adolescent and adult congenital heart disease

Cited by 29 publications

References 47 publications

Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses

Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses

Psychosocial adjustment and quality of life of adolescents and adults with congenital heart disease

Game for health: How eHealth approaches might address the psychological needs of children and young people with long‐term physical conditions

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