Medical predictors for long-term behavioral and emotional outcomes in children and adolescents after invasive treatment of congenital heart disease

J Pediatr Surg. 2010 Nov;45(11):2146-53. doi: 10.1016/j.jpedsurg.2010.07.026.

Abstract

Background: The aim of the study was to test the following: (1) the predictive value of medical variables for long-term parent-reported behavioral and emotional problems in children and adolescents who underwent invasive treatment of congenital heart disease in infancy and (2) the relationship between parental psychological distress and parental reports on problems in children.

Methods: The Child Behavior Checklist was used to investigate to what extent behavioral and emotional problems in 7- to 17-year-old children with congenital heart disease can be predicted by the following: (1) medical history, (2) therapeutic intervention and direct postinterventional course, (3) long-term medical course, (4) present contact with physicians, and (5) present medical status. The General Health Questionnaire was used to assess parental distress (especially anxiety).

Results: Higher Child Behavior Checklist total problems scores were predicted by cardiac medication before therapeutic intervention. Palliative intervention (Rashkind procedure) before therapeutic intervention was associated with more favorable scores on total problems and externalizing. Long-term maternal distress was significantly related to parent-reported problems in children.

Conclusion: Long-term behavioral and emotional outcomes are only marginally predicted by medical variables. In counseling of children with congenital heart disease and their parents, attention should be paid to long-term maternal distress that has an influence on parent-reported problems in children.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Affective Symptoms / etiology*
  • Affective Symptoms / psychology
  • Cardiac Surgical Procedures / psychology*
  • Child
  • Child Behavior*
  • Emotions / physiology
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / psychology
  • Heart Defects, Congenital / surgery*
  • Humans
  • Male
  • Postoperative Period
  • Prognosis
  • Retrospective Studies
  • Sleep Initiation and Maintenance Disorders / etiology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Social Behavior Disorders / etiology*
  • Social Behavior Disorders / psychology
  • Surveys and Questionnaires
  • Time Factors