COVERT FEARS, ANXIETY AND DEPRESSION IN CONGENITAL HEART-DISEASE

This study compared anxiety, fears, depression and behavioural problem s as occurring in children with congenital heart disease, comparing th em with samples of normal children. It further considered the influenc e of maternal anxiety, as well as analyzing a subgroup of children wit h cyanotic forms of congenital heart disease to determine if they were at higher risk than acyanotic children for the problems identified. M ethod: We recruited 40 consecutive children with congenital heart dise ase without obvious psychosocial problems from the Cardiology clinic a t the Alberta Children's Hospital. Of the 40 children, 39 families con sented to have the children participate, of which 24 were cyanotic and 15 acyanotic. Children completed the revised versions of the Fear Sur vey Scale-Revised and the Child Manifest Anxiety Scale as well as the Child Depression Inventory. Mothers completed the Child Behaviour Chec klist, and the State Trait Anxiety Scale. Results: Children with conge nital heart diseases demonstrated more medical fears, and more physiol ogical anxiety, than the normative samples. More specifically, childre n with cyanotic forms of congenital heart disease demonstrated more fe ars of the unknown, physiological anxiety, depression, and delinquent behaviors than the acyanotic children with congenital heart disease. M others of the children with cyanotic forms of congenital heart disease scored higher on both the state and trait scales, with higher materna l anxiety correlating with higher anxiety, medical fears and behaviora l problems in the child. Conclusion: In a clinical setting, children, with congenital heart diseases who do not present with psychological a djustment problems are still at risk for covert physiological anxiety, medical fears, depression and behavioral problems. The children with cyanotic malformations represent a subgroup at higher risk for these p roblems, which may be further exacerbated by increased :maternal anxie ty.