Post-traumatic stress disorder, anxiety, and depression among adults with congenital heart defects

Background Due to invasive treatments and stressors related to heart health, adults with congenital heart defects (CHDs) may have an increased risk of post-traumatic stress disorder (PTSD), anxiety, and/or depressive disorders. Our objectives were to estimate the prevalence of these disorders among individuals with CHDs. Methods Using IBM (R) MarketScan (R) Databases, we identified adults age 18-49 years with >= 2 outpatient anxiety/depressive disorder claims on separate dates or >= 1 inpatient anxiety/depressive disorder claim in 2017. CHDs were defined as >= 2 outpatient CHD claims >= 30 days apart or >= 1 inpatient CHD claim documented in 2007-2017. We used log-binomial regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for associations between CHDs and anxiety/depressive disorders. Results Of 13,807 adults with CHDs, 12.4% were diagnosed with an anxiety or depressive disorder. Adults with CHDs, compared to the 5,408,094 without CHDs, had higher prevalence of PTSD (0.8% vs. 0.5%; aPR: 1.5 [CI: 1.2-1.8]), anxiety disorders (9.9% vs. 7.5%; aPR: 1.3 [CI: 1.3-1.4]), and depressive disorders (6.3% vs. 4.9%; aPR: 1.3 [CI: 1.2-1.4]). Among individuals with CHDs, female sex (aPR range: 1.6-3.3) and inpatient admission (aPR range 1.1-1.9) were associated with anxiety/depressive disorders. Conclusion Over 1 in 8 adults with CHDs had diagnosed PTSD and/or other anxiety/depressive disorders, 30-50% higher than adults without CHDs. PTSD was rare, but three times more common in women with CHDs than men. Screening and referral for services for these conditions in people with CHDs may be beneficial.

Automated summary

Individuals with congenital heart defects (CHDs) have a higher prevalence of post-traumatic stress disorder (PTSD), anxiety, and depressive disorders compared to those without CHDs. Among individuals with CHDs, female sex and inpatient admission are associated with higher rates of anxiety/depressive disorders. Early screening and appropriate referral for mental health services may be beneficial for individuals with CHDs.