Longitudinal development of psychopathology in an adult congenital heart disease cohort

Background: Little is known about the development of psychopathology in patients with congenital heart disease (ConHD) from adolescence into adulthood. In this study, the course of psychopathology in a cohort of ConHD adults, who received their first heart surgery in childhood, was determined longitudinally over a 10-year-period. Methods: At both the first (1989-1991) and second (2000-2001) follow-up, patients (n = 251, aged 20-32 years) completed questionnaires during a psychological examination. Parallel instruments were used to measure psychopathology in adolescence and adulthood. Results: Young ConHD female patients showed higher levels of psychopathology compared to the reference group. Larger differences in psychopathology were found between younger (20-27 years) and older (28-32 years) patients compared to the reference group; the younger patients showed more psychopathology than the older patients. Also, larger differences in psychopathology were found between male and female patients compared to the reference group; female patients showed more psychopathology than male patients. Parents and partners of patients evaluated the patients' behavior as more deviant from the norm than patients themselves. There was a stronger decline of psychopathology in ConHD patients with increasing age compared to reference groups. Female and younger patients showed more variability in trajectories of psychopathology than did male and older patients. Conclusions : Assessment and treatment of psychopathology at a younger age is highly desirable in ConHD patients. Young adult ConHD female patients deserve special attention since they might be hampered by disease-specific uncertainties. (c) 2005 Elsevier Ireland Ltd. All rights reserved.