Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-05-19T13:46:34.270Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychological functioning in paediatric patients with single ventricle heart disease: a systematic review

Published online by Cambridge University Press:  20 January 2022

Amanda D. McCormick Open the ORCID record for Amanda D. McCormick [Opens in a new window] ,
Megan M. Wilde ,
Christine E. Charpie ,
Kate M. Saylor ,
Sunkyung Yu ,
Kurt R. Schumacher  and
Melissa K. Cousino Open the ORCID record for Melissa K. Cousino [Opens in a new window]
Amanda D. McCormick*
Affiliation:
Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Megan M. Wilde
Affiliation:
Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Christine E. Charpie
Affiliation:
College of Literature, Science and the Arts, University of Michigan, Ann Arbor, MI, USA
Kate M. Saylor
Affiliation:
Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
Sunkyung Yu
Affiliation:
Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Kurt R. Schumacher
Affiliation:
Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Melissa K. Cousino
Affiliation:
Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
*
Author for correspondence: Amanda D. McCormick, MD, Department of Pediatrics, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA. Tel: +1 330-289-4871. E-mail: acdelong@med.umich.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Patients with single ventricle heart disease are living into adulthood due to medical and surgical advancements but have significant physical comorbidities and an increased risk for psychological comorbidities compared to healthy subjects or those with other CHD diagnoses. This study aimed to systematically review psychological functioning in paediatric single ventricle heart disease.

Methods:

Literature was searched using PubMed, Embase, PsycInfo, CINAHL Complete and Scopus. Peer-reviewed articles that included patients ages 0–25 years with single ventricle heart disease, and quantitative measures of psychological outcomes were included. Meta-analysis using a fixed-effect model was conducted for internalising and externalising t-scores, utilised by the Achenbach Child Behavior Checklist.

Results:

Twenty-nine records met the criteria for inclusion. 13/24 studies demonstrated increased risk for internalising disorders, such as anxiety/depression; 16/22 studies demonstrated risk for externalising disorders, such as attention or behavioural problems. Meta-analysis of four studies revealed that paediatric single ventricle heart disease patients had no significant difference in internalising and externalising t-scores compared to normative values.

Conclusions:

The current review demonstrates the need for further studies to better understand psychological functioning in patients with single ventricle heart disease, with a majority of studies showing increased risk for psychological problems despite no difference seen in a small meta-analysis. This summary of the literature underscores the need for regular psychological screening, earlier intervention and integrated mental health therapies in paediatric single ventricle heart disease.

Type
Review
Information
Cardiology in the Young , Volume 32 , Issue 2 , February 2022 , pp. 173 - 184
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fontan, F, Baudet, E. Surgical repair of tricuspid atresia. Thorax 1971; 26: 240–248.CrossRefGoogle ScholarPubMed
dʼUdekem, Y, Iyengar, AJ, Cochrane, AD, et al. The fontan procedure: contemporary techniques have improved long-term outcomes. Circulation 2007; 116: I157–164.CrossRefGoogle ScholarPubMed
Stewart, RD, Pasquali, SK, Jacobs, JP, et al. Contemporary fontan operation: association between early outcome and type of cavopulmonary connection. Ann Thorac Surg 2012; 93: 1254–1260, discussion 1261.CrossRefGoogle ScholarPubMed
Poh, CL, dʼUdekem, Y. Life after surviving fontan surgery: a Meta-Analysis of the incidence and predictors of late death. Heart Lung Circ 2018; 27: 552–559.CrossRefGoogle ScholarPubMed
Atz, AM, Zak, V, Mahony, L, et al. Longitudinal outcomes of patients with single ventricle after the fontan procedure. J Am Coll Cardiol 2017; 69: 2735–2744.CrossRefGoogle ScholarPubMed
McCormick, AD, Schumacher, KR. Transplantation of the failing fontan. Transl Pediatr 2019; 8: 290–301.CrossRefGoogle ScholarPubMed
Marshall, KH, DʼUdekem, Y, Sholler, GF, et al. Health-Related quality of life in children, adolescents, and adults with a fontan circulation: a Meta-Analysis. J Am Heart Assoc 2020; 9: e014172.CrossRefGoogle ScholarPubMed
DeMaso, DR, Calderon, J, Taylor, GA, et al. Psychiatric disorders in adolescents with single ventricle congenital heart disease. Pediatrics 2017; 139: 319.CrossRefGoogle ScholarPubMed
Luthy, SK, Yu, S, Donohue, JE, Loccoh, E, Goldberg, CS, Lu, JC. Parental preferences regarding outpatient management of children with congenital heart disease. Pediatr Cardiol 2016; 37: 151–159.CrossRefGoogle ScholarPubMed
Jensen, PS, Goldman, E, Offord, D, et al. Overlooked and underserved: "action signs" for identifying children with unmet mental health needs. Pediatrics 2011; 128: 970–979.CrossRefGoogle ScholarPubMed
McMillan, JA, Land, M Jr., Tucker, AE, Leslie, LK. Preparing future pediatricians to meet the behavioral and mental health needs of children. Pediatrics 2020; 145: 1199.CrossRefGoogle ScholarPubMed
Sanz, JH, Anixt, J, Bear, L, et al. Characterisation of neurodevelopmental and psychological outcomes in CHD: a research agenda and recommendations from the cardiac neurodevelopmental outcome collaborative. Cardiol Young 2021; 31: 1–12.CrossRefGoogle ScholarPubMed
Sood, E, Jacobs, JP, Marino, BS. Optimising neurodevelopmental and psychosocial outcomes for survivors with CHD: a research agenda for the next decade. Cardiol Young 2021; 31: 1–3.CrossRefGoogle ScholarPubMed
Levine, GN, Cohen, BE, Commodore-Mensah, Y, et al. Psychological health, well-Being, and the Mind-Heart-Body connection: a scientific statement from the american heart association. Circulation 2021; 143: e763–e783.CrossRefGoogle ScholarPubMed
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535–b2535.CrossRefGoogle Scholar
National Institute of Health National Heart L, and Blood Institute. Study quality assessment tool for observational cohort and cross-sectional studies., https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.Accessed.Google Scholar
Achenbach, T. Manual for the Child Behavior Checklist/4-18 and 1991 Profile. University of Vermont, Department of Psychiatry, Burlington, VT, 1991.Google Scholar
Hedges, L. Distribution theory for glass’s estimator of effect size and related estimators. J Educ Stat 1981; 6: 101–128.CrossRefGoogle Scholar
Borenstein, M, Hedges, L, Higgins, J, Rothstein, H. Introduction to Meta-Analysis. John Wiley & Sons, Ltd, Chicester, UK, 2009.CrossRefGoogle Scholar
Borenstein, M, Hedges, L, Higgins, J, Rothstein, H. Comprenehsive Meta-Analysis Version 3. Biostat, Englewood, NJ, 2013.Google Scholar
Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–560.CrossRefGoogle ScholarPubMed
Casey, FA, Sykes, DH, Craig, BG, Power, R, Mulholland, HC. Behavioral adjustment of children with surgically palliated complex congenital heart disease. J Pediatr Psychol 1996; 21: 335–352.CrossRefGoogle ScholarPubMed
Cassidy, AR, Bernstein, JH, Bellinger, DC, Newburger, JW, DeMaso, DR. Visual-spatial processing style is associated with psychopathology in adolescents with critical congenital heart disease. Clin Neuropsychol 2019; 33: 760–778.CrossRefGoogle ScholarPubMed
Goldberg, CS, Hu, C, Brosig, C, et al. Behavior and quality of life at 6 years for children with hypoplastic left heart syndrome. Pediatrics 2019; 144: 816.CrossRefGoogle ScholarPubMed
Gonzalez, VJ, Kimbro, RT, Cutitta, KE, et al. Mental health disorders in children with congenital heart disease. Pediatrics 2021; 147: 319.CrossRefGoogle ScholarPubMed
Mahle, WT, Clancy, RR, Moss, EM, Gerdes, M, Jobes, DR, Wernovsky, G. Neurodevelopmental outcome and lifestyle assessment in school-aged and adolescent children with hypoplastic left heart syndrome. Pediatrics 2000; 105: 1082–1089.CrossRefGoogle ScholarPubMed
Mellander, M, Berntsson, L, Nilsson, B. Quality of life in children with hypoplastic left heart syndrome. Acta Paediatr 2007; 96: 53–57.CrossRefGoogle ScholarPubMed
Noorani, S, Roy, B, Sahib, AK, et al. Caudate nuclei volume alterations and cognition and mood dysfunctions in adolescents with single ventricle heart disease. J Neurosci Res 2020; 98: 1877–1888.CrossRefGoogle ScholarPubMed
Pike, NA, Roy, B, Gupta, R, et al. Brain abnormalities in cognition, anxiety, and depression regulatory regions in adolescents with single ventricle heart disease. J Neurosci Res 2018; 96: 1104–1118.CrossRefGoogle ScholarPubMed
Puosi, R, Korkman, M, Sarajuuri, A, et al. Neurocognitive development and behavioral outcome of 2-year-old children with univentricular heart. J Int Neuropsychol Soc 2011; 17: 1094–1103.CrossRefGoogle ScholarPubMed
Sarajuuri, A, Lonnqvist, T, Schmitt, F, Almqvist, F, Jokinen, E. Patients with univentricular heart in early childhood: parenting stress and child behaviour. Acta Paediatr 2012; 101: 252–257.CrossRefGoogle ScholarPubMed
Sarrechia, I, Miatton, M, De Wolf, D, et al. Neurocognitive development and behaviour in school-aged children after surgery for univentricular or biventricular congenital heart disease. Eur J Cardiothorac Surg 2016; 49: 167–174.CrossRefGoogle ScholarPubMed
Vahsen, N, Broder, A, Hraska, V, Schneider, M. Neurodevelopmental outcome in children with single ventricle after total cavopulmonary connection. Klin Padiatr 2018; 230: 24–30.Google ScholarPubMed
Brosig, CL, Mussatto, KA, Kuhn, EM, Tweddell, JS. Neurodevelopmental outcome in preschool survivors of complex congenital heart disease: implications for clinical practice. J Pediatr Health Care 2007; 21: 3–12.CrossRefGoogle ScholarPubMed
Brosig, C, Mussatto, K, Hoffman, G, et al. Neurodevelopmental outcomes for children with hypoplastic left heart syndrome at the age of 5 years. Pediatr Cardiol 2013; 34: 1597–1604.CrossRefGoogle ScholarPubMed
Calderon, J, Stopp, C, Wypij, D, et al. Early-Term birth in single-Ventricle congenital heart disease after the fontan procedure: neurodevelopmental and psychiatric outcomes. J Pediatr 2016; 179: 96–103.CrossRefGoogle ScholarPubMed
dʼUdekem, Y, Cheung, MM, Setyapranata, S, et al. How good is a good fontan? quality of life and exercise capacity of fontans without arrhythmias. Ann Thorac Surg 2009; 88: 1961–1969.CrossRefGoogle ScholarPubMed
Davidson, J, Gringras, P, Fairhurst, C, Simpson, J. Physical and neurodevelopmental outcomes in children with single-ventricle circulation. Arch Dis Child 2015; 100: 449–453.CrossRefGoogle ScholarPubMed
Goldberg, CS, Schwartz, EM, Brunberg, JA, et al. Neurodevelopmental outcome of patients after the fontan operation: a comparison between children with hypoplastic left heart syndrome and other functional single ventricle lesions. J Pediatr 2000; 137: 646–652.CrossRefGoogle ScholarPubMed
Hagemo, PS, Rasmussen, M, Bryhn, G, Vandvik, IH. Hypoplastic left heart syndrome: multiprofessional Follow-up in the Mid-term following palliative procedures. Cardiol Young 1997; 7: 248–253.CrossRefGoogle Scholar
Hagemo, PS, Skarbo, AB, Rasmussen, M, Fredriksen, PM, Schage, S. An extensive long term follow-up of a cohort of patients with hypoplasia of the left heart. Cardiol Young 2007; 17: 51–55.CrossRefGoogle ScholarPubMed
McCusker, CG, Doherty, NN, Molloy, B, et al. Determinants of neuropsychological and behavioural outcomes in early childhood survivors of congenital heart disease. Arch Dis Child 2007; 92: 137–141.CrossRefGoogle ScholarPubMed
Overgaard, D, Schrader, AM, Lisby, KH, et al. Patient-reported outcomes in adult survivors with single-ventricle physiology. Cardiology 2011; 120: 36–42.CrossRefGoogle ScholarPubMed
Saliba, Z, Butera, G, Bonnet, D, et al. Quality of life and perceived health status in surviving adults with univentricular heart. Heart 2001; 86: 69–73.Google ScholarPubMed
Bellinger, DC, Watson, CG, Rivkin, MJ, et al. Neuropsychological status and structural brain imaging in adolescents with single ventricle who underwent the fontan procedure. J Am Heart Assoc 2015; 4: 216.CrossRefGoogle ScholarPubMed
Fuller, S, Rajagopalan, R, Jarvik, GP, etal J. Maxwell chamberlain memorial paper for congenital heart surgery. deep hypothermic circulatory arrest does not impair neurodevelopmental outcome in school-age children after infant cardiac surgery. Ann Thorac Surg 2010; 90: 1985–1994, discussion 1994-1985.CrossRefGoogle Scholar
Hansen, E, Poole, TA, Nguyen, V, et al. Prevalence of ADHD symptoms in patients with congenital heart disease. Pediatr Int 2012; 54: 838–843.CrossRefGoogle ScholarPubMed
Sistino, JJ, Atz, AM, Simpson, KN, Ellis, C, Ikonomidis, JS, Bradley, SM. The prevalence of attention-deficit/hyperactivity disorder following neonatal aortic arch repair. Cardiol Young 2015; 25: 663–669.CrossRefGoogle ScholarPubMed
Denniss, DL, Sholler, GF, Costa, DSJ, Winlaw, DS, Kasparian, NA. Need for routine screening of health-Related quality of life in families of young children with complex congenital heart disease. J Pediatr 2019; 205: 21–28 e22.CrossRefGoogle ScholarPubMed
Luyckx, K, Rassart, J, Goossens, E, Apers, S, Oris, L, Moons, P. Development and persistence of depressive symptoms in adolescents with CHD. Cardiol Young 2016; 26: 1115–1122.CrossRefGoogle ScholarPubMed
Karsdorp, PA, Everaerd, W, Kindt, M, Mulder, BJ. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 2007; 32: 527–541.CrossRefGoogle ScholarPubMed
Kovacs, AH, Saidi, AS, Kuhl, EA, et al. Depression and anxiety in adult congenital heart disease: predictors and prevalence. Int J Cardiol 2009; 137: 158–164.CrossRefGoogle ScholarPubMed
Wang, CC, Weng, WC, Chang, LY, et al. Increased prevalence of inattention-related symptoms in a large cohort of patients with congenital heart disease. Eur Child Adolesc Psychiatry 2021; 30: 647–655.CrossRefGoogle Scholar
Holland, JE, Cassidy, AR, Stopp, C, et al. Psychiatric disorders and function in adolescents with tetralogy of fallot. J Pediatr 2017; 187: 165–173.CrossRefGoogle ScholarPubMed
Yamada, DC, Porter, AA, Conway, JL, et al. Early repair of congenital heart disease associated with increased rate of attention deficit hyperactivity disorder symptoms. Can J Cardiol 2013; 29: 1623–1628.CrossRefGoogle ScholarPubMed
Cherkasova, MV, Roy, A, Molina, BSG, et al. Review: adult outcome as seen through controlled prospective Follow-up studies of children with Attention-Deficit/Hyperactivity disorder followed into adulthood. J Am Acad Child Adolesc Psychiatry 2021. DOI 10.1016/j.jaac.2021.05.019. [Online ahead of print].CrossRefGoogle ScholarPubMed
Ko, JM, Tecson, KM, Rashida, VA, et al. Clinical and psychological drivers of perceived health status in adults with congenital heart disease. Am J Cardiol 2018; 121: 377–381.CrossRefGoogle ScholarPubMed
Carazo, MR, Kolodziej, MS, DeWitt, ES, et al. Prevalence and prognostic association of a clinical diagnosis of depression in adult congenital heart disease: results of the boston adult congenital heart disease biobank. J Am Heart Assoc 2020; 9: e014820.CrossRefGoogle ScholarPubMed
Desai, R, Patel, K, Dave, H, etal, Nationwide Frequency. Sequential trends, and impact of Co-morbid mental health disorders on hospitalizations, outcomes, and healthcare resource utilization in adult congenital heart disease. Am J Cardiol 2020; 125: 1256–1262.CrossRefGoogle ScholarPubMed
Latal, B, Helfricht, S, Fischer, JE, Bauersfeld, U, Landolt, MA. Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review. BMC Pediatr 2009; 9: 6.CrossRefGoogle ScholarPubMed
Moons, P, Luyckx, K, Thomet, C, etal, Physical Functioning. Mental health, and quality of life in different congenital heart defects: comparative analysis in 3538 patients from 15 countries. Can J Cardiol 2021; 37: 215–223.CrossRefGoogle ScholarPubMed
Rychik, J, Atz, AM, Celermajer, DS, et al. Evaluation and management of the child and adult with fontan circulation: a scientific statement from the american heart association. Circulation 2019; 140: CIR0000000000000696.CrossRefGoogle Scholar
Reynolds, CR, Kamphaus, RW. Behavior assessment system for children--Third Edition (BASC-3). Pearson, Bloomington, MN, 2015.Google Scholar
Ware, J, Butcher, JL, Latal, B, et al. Neurodevelopmental evaluation strategies for children with congenital heart disease aged birth through 5 years: recommendations from the cardiac neurodevelopmental outcome collaborative. Cardiol Young 2020; 30: 1609–1622.CrossRefGoogle ScholarPubMed
Ilardi, D, Sanz, JH, Cassidy, AR, et al. Neurodevelopmental evaluation for school-age children with congenital heart disease: recommendations from the cardiac neurodevelopmental outcome collaborative. Cardiol Young 2020; 30: 1623–1636.CrossRefGoogle ScholarPubMed
Harris, E, Bowden, J, Greiner, E, Duby, JC. Mental health training in pediatric residency: where can we go? J Pediatr 2019; 211: 4–6.CrossRefGoogle Scholar
McMillan, JA, Land, M Jr., Leslie, LK. Pediatric residency education and the behavioral and mental health crisis: a call to action. Pediatrics 2017; 139: 1199.CrossRefGoogle ScholarPubMed
Cassidy, AR, Butler, SC, Briend, J, et al. Neurodevelopmental and psychosocial interventions for individuals with CHD: a research agenda and recommendations from the cardiac neurodevelopmental outcome collaborative. Cardiol Young 2021; 31: 1–12.CrossRefGoogle ScholarPubMed
Tesson, S, Butow, PN, Sholler, GF, Sharpe, L, Kovacs, AH, Kasparian, NA. Psychological interventions for people affected by childhood-onset heart disease: a systematic review. Health Psychol 2019; 38: 151–161.CrossRefGoogle ScholarPubMed
Moon, JR, Huh, J, Kang, I-S, Park, SW, June, T-G, Lee, HJ. Relationship between depression and resilience in adolescents with congenital heart disease. Am Heart Assoc, in, 2006.CrossRefGoogle Scholar
Alsaied, T, Allen, KY, Anderson, JB, et al. The fontan outcomes network: first steps towards building a lifespan registry for individuals with fontan circulation in the United States. Cardiol Young 2020; 30: 1070–1075.CrossRefGoogle ScholarPubMed
Sood, E, Jacobs, JP, Marino, BS. The cardiac neurodevelopmental outcome collaborative: a new community improving outcomes for individuals with congenital heart disease. Cardiol Young 2020; 30: 1595–1596.CrossRefGoogle ScholarPubMed
Supplementary material: File

McCormick et al. supplementary material

McCormick et al. supplementary material

Download McCormick et al. supplementary material(File)
File 13.4 KB