Skip to main content
SpringerLink
Log in

Children and adolescents with congenital heart disease: assessment of behavioural and emotional problems

  • ORIGINAL CONTRIBUTION
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Objective

The objective of the study was to assess behavioural and emotional problems in children and adolescents with congenital cardiac disease.

Design

From the database of Paediatric Heart Section, Rikshospitalet University Hospital, Norway, 430 patients and their parents were included and received questionnaires of youth self-report and child behavior checklist. The response rate was 71.4%.

Results

Compared to their parents children with congenital heart disease reported more behavioural and emotional problems. Boys scored significantly higher than girls in total problem score and externalising scores with more social problems, attention problems, delinquent behaviour and aggressive behaviour. No gender difference was found regarding internalising problem score. Compared to healthy boys, no differences were found in total problem, externalising or internalising score. In girls lower values were found in patients than healthy children for total problem, externalising and internalising scores.

Conclusions

In the present study boys scored themselves higher with regard to total problem score than girls. No effect was found of due to different diagnoses. The data indicate that the children experience more problems than the parents are aware of. However, the behaviour problem scores in children with cardiac disease are significantly lower than in healthy children. A close parental follow-up and an experience of being exposed to life-threatening situation may play a role for the latter results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Achenbach TM (1991) Integrative Guide for the 1991 CBCL/4–18, YSR and TRF-profiles. Department of psychiatry, University of Vermont

  2. Broberg A, Ekeroth K, Gustafsson P, Hansson K, Hägglöf B, Ivarsson T et al (2001) Self-reported comptencies and problems among Swedish adolescents: a normative study of the YSR. Eur Child Adolesc Psychiatry 10:186–93

    Article  CAS  Google Scholar 

  3. Bellinger DC, Wernovsky G, Rappaport LA, Mayer JE, Castaneda AR, Farrell DM et al (1991) Congenitive development of children following early repair of Transposition of the Great Arteries using deep hypothermic circulatory arrest. Pediatrics 87(5):701–707

    PubMed  CAS  Google Scholar 

  4. Care of the adult with congenital heart disease. Presented at the 32nd Bethesda Conference, October 2000 2001 p. 1161–98

  5. Casey FA, Sykes DH, Craig BG, Power R, Mulholland HC (1996) Behavioral adjustment of children with surgically palliated complex congenital heart disease. J Pediatr Psychol 21(3):335–352

    Article  PubMed  CAS  Google Scholar 

  6. DeMaso DR, Beardslee WR, Silbert AR, Fyler DC (1990) Psychological functioning in children with cyanotic heart defects. J Dev Behav Pediatr 11(6):289–294

    Article  PubMed  CAS  Google Scholar 

  7. Diseth TH, Bjornland K, Novik TS, Emblem R (1997) Bowel function, mental health, and psychosocial function in adolescents with Hirschsprung’s disease. Arch Dis Child 76(2):100–106

    Article  PubMed  CAS  Google Scholar 

  8. DeMaso DR, Campis LK, Wypij D, Bertram S, Lipshitz M, Freed M (1991) The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Pediatr Psychol 16(2):137–49

    Article  PubMed  CAS  Google Scholar 

  9. Eskedal L, Hagemo PS, Eskild A, Aamodt G, Seiler KS, Thaulow E (2005) Survival after surgery for congenital heart defects: Does reduced early mortality predict improved long-term survival? Acta Paediatrica 94(4):438–443

    PubMed  Google Scholar 

  10. Fredriksen PM, Mengshoel AM, Frydenlund A, Soerbye O, Thaulow E (2004) Follow-up in patients with congenital cardiac disease, more complex than haemodynamic assessment. Cardiol Young 14:373–379

    Article  PubMed  Google Scholar 

  11. Fitzpatrick C, Deehan A (1999) Competencies and problems of Irish children and adolescents. Eur Child Adolesc Psychiatry 8:17–23

    Article  PubMed  CAS  Google Scholar 

  12. Fredriksen PM, Ingjer F, Nystad W, Thaulow E (1999) A comparison of VO2 peak between patients with CHD and healthy subjects, all aged 8–17 years. Eur J Appl Physiol Occup Physiol 80(5):409–416

    Article  PubMed  CAS  Google Scholar 

  13. Fredriksen PM, Ingjer F, Thaulow E (2000) Physical activity in children and adolescents with congenital heart disease. Aspects of measurements with an activity monitor. Cardiol Young 10:98–106

    PubMed  CAS  Google Scholar 

  14. Gjone H, Nøvik TS (1995) Parental ratings of behavior problems: a twin and general population comparison. J Child Pcychol Psychiatry 36:1213–1224

    Article  CAS  Google Scholar 

  15. Higgins SS, Tong E (2003) Transitioning adolescents with congenital heart disease into adult health care. Prog Cardiovasc Nurs 18(2):93–98

    PubMed  Google Scholar 

  16. Hovels-Gurich HH, Konrad K, Wiesner M, Minkenberg R, Herpertz-Dahlmann B, Messmer BJ et al (2002) Long term behavioural outcome after neonatal arterial switch operation for transposition of the great arteries. Arch Dis Childhood 87(6):506–510

    Article  CAS  Google Scholar 

  17. Heyerdahl S, Kvernmo S, Wichstrøm L (2004) Self-reported behaioursl/emotional problems in Norwegian adolescents from multiethnic areas. Eur Child Adolesc Psychiatry 13:64–72

    Article  PubMed  Google Scholar 

  18. Kamphuis M, Vliegen HW, Vogels T, Zwinderman KH, van der Wall EE, Verloove-Vanhorick SP et al (2002) The need for cardiac follow-up in adults with mild congenital cardiac disease. Cardiol Young 12(5):474–8

    Article  PubMed  Google Scholar 

  19. Kovacs AH, Sears SF, Saidi AS (2005) Biopsychosocial experiences of adults with congenital heart disease: review of the literature. Am Heart J 150(2):193–201

    Article  PubMed  Google Scholar 

  20. Kitchen LW (1978) Psychological factors in congenital heart disease in children. J Fam Pract 6(4):777–783

    PubMed  CAS  Google Scholar 

  21. Kokkonen J, Paavilainen T (1992) Social adaptation of young adults with congenital heart disease. Int J Cardiol 36(1):23–29

    Article  PubMed  CAS  Google Scholar 

  22. Kramer HH, Awiszus D, Sterzel U, van Halteren A, Classen R (1989) Development of personality and intelligence in children with congenital heart disease. J Child Pcychol Psychiatry 30(2):299–308

    Article  CAS  Google Scholar 

  23. Karl TR, Hall S, Ford G, Kelly EA, Brizard CP, Mee RB et al (2004) Arterial switch with full-flow cardiopulmonary bypass and limited circulatory arrest: neurodevelopmental outcome. J Thorac Cardiovasc Surg 127(1):213–22

    Article  PubMed  Google Scholar 

  24. Kvernmo S, Heyerdahl S (1998) Influence of ethnic factors on behavior problems in indigenous Sami and majority Norwegian adolescents. J Am Acad Child Adolesc Psychiatry 37:743–51

    Article  PubMed  CAS  Google Scholar 

  25. Lane DA, Lip GY, Millane TA (2002) Quality of life in adults with congenital heart disease. Heart 88(1):71–75

    Article  PubMed  CAS  Google Scholar 

  26. Linde LM (1982) Psychiatric aspects of congenital Heart Disease. Psychiatric Clinics North Am 5(2):399–407

    CAS  Google Scholar 

  27. Linde LM, Rasof B, Dunn OJ (1970) Longitudinal studies of intellectual and behavioral development in children with congenital heart disease. Acta Paediatr Scand 59:169–76

    Article  PubMed  CAS  Google Scholar 

  28. Ludman L. Psychological aspects of pediatric surgery (2006) In: Stringer MD, Oldham KT, Mouriquand PDE (eds) Pediatric Surgery and Urology, Long-term Outcome. Cambridge University Press, New York

    Google Scholar 

  29. McCusker CG, Doherty NN, Molloy B, Casey F, Rooney N, Mulholland C et al (2007) Determinants of neuropsychological and behavioural outcomes in early childhood survivors of congenital heart disease. Arch Dis Child 92(2):137–141

    Article  PubMed  CAS  Google Scholar 

  30. Majnemer A, Limperopoulos C, Shevell M, Rohlicek C, Rosenblatt B, Tchervenkov C (2006) Health and well-being of children with congenital cardiac malformations, and their families, following open-heart surgery. Cardiol Young 16(2):157–164

    Article  PubMed  Google Scholar 

  31. Nøvik TS (1995) Are postal surveys in child psychiatry feasible? Results of an epidemiological study. Nordic J Pshychiatry 49:337–342

    Article  Google Scholar 

  32. Oates RK, Simpson JM, Cartmill TB, Turnbull JAB (1995) Intellectual function and age of repair in cyanotic congenital heart disease. Arch Dis Child 72:298–301

    Article  PubMed  CAS  Google Scholar 

  33. Somerville J (2002) Grown-up Congenital Heart (GUCH) Disease: current needs and provisions of service for adolescents and adults with congenital heart disease in the UK. Heart 88(Suppl 1):1–14

    Google Scholar 

  34. Spijkerboer AW, Utens EM, Bogers AJ, Verhulst FC, Helbing WA (2007) Long-term behavioural and emotional problems in four cardiac diagnostic groups of children and adolescents after invasive treatment for congenital heart disease. Int J Cardiol, 10 April

  35. Tonstad S, Nøvik TS, Vandvik IH (1996) Psychosocial function during treatment for familial hypercholesteroelmia. Pediatrics 98(2):249–255

    PubMed  CAS  Google Scholar 

  36. Utens EM, Verluis-Den Bieman HJ, Verhulst FC, Meijboom FJ, Erdman RA, Hess J (1998) Psychopathology in young adults with congenital heart disease. Eur Heart J 19:647–651

    Article  PubMed  CAS  Google Scholar 

  37. Utens EM, Verhulst FC, Erdman RA, Meijboom FJ, Duivenvoorden HJ, Bos E et al (1994) Psychosocial functioning of young adults after surgical correction for congenital heart disease in childhood: a follow-up study. J Psychosom Res 38(7):745–758

    Article  PubMed  CAS  Google Scholar 

  38. Utens EM, Verhulst FC, Meijboom FJ, Duivenvoorden HJ, Erdman RA, Bos E et al (1993) Behavioural and emotional problems in children and adolescents with congenital heart disease. Psychol Med 23(2):415–424

    Article  PubMed  CAS  Google Scholar 

  39. Utens EM, Verhulst FC, Duivenvoorden HJ, Meijboom FJ, Erdman RA, Hess J (1998) Prediction of behavioural and emotional problems in children and adolescents with operated congenital heart disease. Eur Heart J 19(5):801–807

    Article  PubMed  CAS  Google Scholar 

  40. van der Rijken RE, Maassen BA, Walk TL, Daniels O, Hulstijn-Dirkmaat GM (2007) Outcome after surgical repair of congenital cardiac malformations at school age. Cardiol Young 17(1):64–71

    Article  PubMed  Google Scholar 

  41. van Rijen EH, Utens EM, Roos-Hesselink JW, Meijboom FJ, van Domburg RT, Roelandt JR et al (2004) Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 25(18):1605–1613

    Article  PubMed  Google Scholar 

  42. Verhulst FC, Koot HM (1992) Child psychiatric epidemiology. Concepts, methods, and findings [23]. Newbury Park

  43. Verhulst FC, Achenbach TM, Ferdinand R, Kasius M (1993) Epidemiological comparisons of American and Dutch adolescents’ self-reports. J Am Acad Child Adolesc Psychiatry 32:1135–1144

    Article  PubMed  CAS  Google Scholar 

  44. Verhulst FC, Prince J, Vervuurt-Poot C, de Jong J (1989) Mental health in Dutch adolescents: self-reported competencies and problems for ages 11–18. Acta Psychiatr Scand 356(Suppl):1–48

    Article  CAS  Google Scholar 

  45. Wells FC, Coghill S, Caplan HL, Lincoln C (1983) Duration of ciculatory arrest does influence the psychological development of children after cardiac operation in early life. J Thorac Cardiovasc Surg 86:823–31

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinic of Clinical Service, Rikshospitalet University Hospital, Oslo, Norway

    Per Morten Fredriksen

  2. Section for Child and Adolescent Psychiatry, Paediatric Clinic, Rikshospitalet University Hospital, Oslo, Norway

    Trond H. Diseth

  3. Paediatric Heart Section, Paediatric Clinic, Rikshospitalet University Hospital, Oslo, Norway

    Erik Thaulow

  4. Research Unit, Rehabilitation Clinic, Rikshospitalet University Hospital, Sognsvannsveien 20, 0027, Oslo, Norway

    Per Morten Fredriksen

Authors
  1. Per Morten Fredriksen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Trond H. Diseth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erik Thaulow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Per Morten Fredriksen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fredriksen, P.M., Diseth, T.H. & Thaulow, E. Children and adolescents with congenital heart disease: assessment of behavioural and emotional problems. Eur Child Adolesc Psychiatry 18, 292–300 (2009). https://doi.org/10.1007/s00787-008-0730-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-008-0730-8

Keywords

Search

Navigation