This article is more than 5 years old. Information may no longer be current.
Adults with congenital heart disease may be at elevated risk for PTSD
Results from a single-center study indicate that adults with congenital heart disease, particularly those who had surgery before 1990, appear to have a higher rate of PTSD than the general population.
The relationship between PTSD and adult congenital heart disease was unknown, so researchers assessed the prevalence of self-reported PTSD symptoms in 134 participants (mean age, 34.6 years; 46% men) with adult congenital heart disease and examined associated factors.
Unique stressors
“Although the life expectancy of adults living with [congenital heart disease] has improved, ongoing care may include multiple surgeries and procedures,” Yuli Kim, MD, cardiologist at The Children’s Hospital of Philadelphia and director of the Philadelphia Adult Congenital Heart Center, said in a press release. “These patients remain at risk for both cardiac and noncardiac effects of their chronic condition and face unique life stressors that may place them at elevated risk for psychological stress.”
Yuli Kim
Kim and colleagues administered two questionnaires to determine PTSD symptoms to participants: Impact of Event Scale-Revised and PTSD Checklist-Civilian Version. They also administered the Hospital Anxiety and Depression Scale questionnaire to determine depressive symptoms.
They found that of the 127 individuals who completed the Impact of Event Scale-Revised questionnaire, 14 (11%) attained criteria indicating elevated PTSD symptoms related to their disease or treatment.
They also found that of the 134 who completed the PTSD Checklist-Civilian Version questionnaire, 27 (21%) gave responses indicating global PTSD symptoms.
In a univariate analysis, Kim and colleagues determined that compared with those not meeting PTSD criteria, those who met PTSD criteria were more likely to have had their most recent surgery before 1990 (P = .008), were less likely to have gone to college (P = .04), were more likely to have had stroke or transient ischemic attack (P = .03) and had greater depressive symptoms as indicated by Hospital Anxiety and Depression Scale score (7 vs. 2; P < .001).
In a multivariable analysis, the year of most recent surgery for each 1-year increase (OR = 0.88; 95% CI, 0.8-0.97) and high Hospital Anxiety and Depression Scale score (OR = 1.64; 95% CI, 1.17-2.29) were the most significant predictors of PTSD symptoms in the study population.
High prevalence
The 11% to 21% prevalence of PTSD in the study population is higher than the 3.5% prevalence seen in the general population and is comparable to that seen in children with congenital heart disease and adults with acquired heart disease, the researchers wrote.
“Advances in anesthetic and perioperative management may explain this association of PTSD with early era of surgical repair,” Kim and colleagues wrote. “Our results are also supported by the ‘residual stress’ theory of PTSD, which suggests that traumatic stressors may produce chronic, lasting effects. Another possible explanation is that patients with more recent ‘exposure’ may have learned to reinterpret earlier events as being less traumatic and more manageable.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.