Prevalence of Mental Illness in Adolescents and Adults With Congenital Heart Disease from the Colorado Congenital Heart Defect Surveillance System

• Published in: The American journal of cardiology Vol. 124; no. 4; pp. 618 - 626
• Main Authors: Khanna, Amber D., Duca, Lindsey M., Kay, Joseph D., Shore, Jay, Kelly, Sarah L., Crume, Tessa
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15-08-2019; Elsevier Limited
• Subjects: Adolescent; Adolescents; Adult; Adults; Age; Anxiety; Anxiety Disorders - epidemiology; Attention Deficit and Disruptive Behavior Disorders - epidemiology; Cardiovascular disease; Cardiovascular diseases; Child; Codes; Colorado - epidemiology; Congenital diseases; Coronary artery disease; Defects; Delirium; Dementia; Developmental disabilities; Diagnosis; DiGeorge Syndrome - epidemiology; Disorders; Down Syndrome - epidemiology; Female; Fragile X Syndrome - epidemiology; Genetic disorders; Gonadal Dysgenesis - epidemiology; Health care; Health insurance; Heart; Heart Defects, Congenital - epidemiology; Heart diseases; Hospitals; Humans; Impulsive behavior; Male; Marfan Syndrome - epidemiology; Mental disorders; Mental Disorders - epidemiology; Mental health; Mental health care; Middle Aged; Mood; Mood Disorders - epidemiology; Morbidity; Patients; Prader-Willi Syndrome - epidemiology; Prevalence; Pulmonary arteries; Schizophrenia; Severity of Illness Index; Substance-Related Disorders - epidemiology; Surveillance; Teenagers; Young Adult; Colorado; United States > US
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2019.05.023

The aim of this study was to estimate the prevalence of the full spectrum of mental illness in adolescents (aged 11 to 17) and adults (aged 18 to 64) with congenital heart defects (CHDs) in the population-level Colorado Congenital Heart Disease Surveillance System. Further we sought to investigate whether severity of the defect, frequency of recent cardiac procedures or underlying genetic disorders influence these estimates. The cohort included patients in clinical care for CHDs between January 1, 2011 and December 31, 2013, identified across multiple healthcare systems and insurance claims. Of 2,192 adolescents with CHDs, 20% were diagnosed with a mental illness with the most prevalent categories being developmental disorders (8%), anxiety disorders (6%), attention, conduct, behavior, impulse control disorders (6%), and mood disorders (5%). Of 6,924 adults with CHDs, 33% were diagnosed with a mental illness with the most prevalent categories being mood disorders (13%), anxiety disorders (13%), and substance-related disorders (6%). Greater lesion complexity was associated with a higher likelihood of anxiety and developmental disorders in both adolescents and adults. Adolescents and adults who had ≥2 cardiac procedures in the 3-year surveillance period had a 3- and 4.5-fold higher likelihood of a mental illness diagnosis, respectively, compared with those who had fewer than 2 cardiac procedures. Finally, patients with a genetic syndrome were more likely to have a mental illness diagnosis. In conclusion, mental illness is a prevalent co-morbidity in the adolescent and adult population with CHDs, thus comprehensive care should include mental health care.