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05-10-2011 | Cardiology | Article

Congenital heart defect patients at risk for psychiatric disorders


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MedWire News: Patients with congenital heart defects (CHD) are at increased risk for psychiatric disorders, say Danish researchers.

These findings emphasize the importance of addressing mental health matters in CHD care, comment Morten Olsen (Aarhus University Hospital) and colleagues in the journal Circulation.

Their study involved 6927 CHD patients from the Danish National Registry of Patients who were born between 1977 and 2002. Each patient was matched by gender and birth year to 10 population-comparison cohort members from the Danish Civil Registration System.

The results showed that at 15 years of age, the cumulative risk for first inpatient admission or outpatient visit for any psychiatric disorder including psychotic disorders (eg, schizophrenia), pervasive developmental disorder, developmental disorder of speech, motor function and learning, or mental retardation in a CHD patient was 5.9%.

Male and female CHD patients aged 0-14 years were a respective 1.8 and 2.5 times more likely to be admitted to hospital or have an outpatient visit for a psychiatric disorder, than comparison cohort members of the same age.

The association between CHD and psychiatric disorders was significant in patients aged under 15 years, regardless of whether they had undergone catheter-based intervention or not, at respective hazard ratios (HRs) of 2.22 and 1.72.

The same association was also seen in men older than 15 years of age, who were at a 1.57-fold greater risk for psychiatric disorders than the general population cohort, but not in women of the same age.

After excluding patients and controls with extracardiac defects and those born preterm, both factors which have been associated with psychiatric disorders, the association between CHD and psychiatric disorders persisted.

Compared with population cohort members who had diabetes, asthma, or both, CHD patients' risk for psychiatric disorders was increased in those aged 0-14 years (HR=1.41) and decreased in those aged 15-30 years (HR=0.70). In a separate analysis including only diabetes patients or asthma patients, the HRs did not vary.

"The increased occurrence of psychotic disorders that we identified among CHD patients compared with the general population cohort may be due, at least in part, to the 22q11.2 deletion syndrome (also known as velocardiofacial syndrome or DiGeorge syndrome) that is associated with CHD," the authors propose.

However, they acknowledge that since the HR for psychiatric disorders remained increased after they excluded patients with extracardiac defects, "additional mechanisms may be relevant."

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