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, β = -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.