TY - EJOU
AU - Udholm, Sebastian
AU - Nyboe, Camilla
AU - Dantoft, Thomas Meinertz
AU - Jørgensen, Torben
AU - Rask, Charlotte U.
AU - Hjortdal, Vibeke E.
TI - Small atrial septal defects are associated with psychiatric diagnoses, emotional distress, and lower educational levels
T2 - Congenital Heart Disease
PY - 2019
VL - 14
IS - 5
SN - 1747-0803
AB - Objective: For the first time, we wish to assess the psychiatric burden in adult patients
living with small, unrepaired atrial septal defects (ASD) using register‐based data, com‐
bined with self‐reported measures on levels emotional distress and educational status.
Design: A descriptive study using both the unique Danish registries and validated
psychiatric questionnaires and scales, including: The Symptom Checklist, Whiteley‐7,
and Brief Illness Perception Questionnaire.
Patients: Adult patients with small, unrepairedASD, diagnosed between 1953 and 2011.
Outcome Measures: Number of register‐based psychiatric diagnoses. Additionally,
symptoms of anxiety, depression, somatization, health anxiety, illness perception,
and levels of educational attainment compared to age‐ and gender‐matched individu‐
als from the reference group.
Results: We identified 723 Danish patientswith a small, unrepairedASD.Approximately
17% of the patients eligible for inclusion had one or more psychiatric diagnoses. The
most common diagnoses were neurotic, stress‐related, and somatoform disorders. A
total of 140 patients (mean age 33 years) was included for examination of their mental
health using psychiatric questionnaires and scales. Patients with small ASD had higher
scores of depression and anxiety when compared to the reference group (0.57 ± 0.67
vs 0.39 ± 0.52; P < .001). Furthermore, patients reported more symptoms of somati‐
zation (0.51 ± 0.48 vs 0.34 ± 0.39; P < .001). Finally, a higher percentage of patients
with an unrepaired ASD had no education beyond high school when compared to the
reference group (33.3% vs 14.3%; P < .001) and a smaller proportion of patients had
completed a short‐cycle higher education (6.5% vs 16.1%; P = .002).
Conclusion: Patients with a small, unrepaired ASD in adult life have more symptoms of
anxiety, depression, and somatization compared to the reference group. Furthermore,
fewer patients had no education beyond high school. These results support the guide‐
lines that adults with small ASD warrants regular lifelong follow‐up in specialized clinics
aware of not only adverse somatic outcome but also rates of depression and anxiety
KW - atrial septal defect
KW - epidemiology
KW - grown‐up congenital heart disease (GUCH)
KW - mental health
KW - psychiatric disorders
KW - simple lesions
DO - 10.1111/chd.12808