Emotional Functioning

The literature describing emotional functioning in children and adolescents with heart disease is often contradictory. Several reviews of the relevant literature have been unable to achieve a consensus on the psychiatric outcomes in youngsters with CHD (Griffin et al. 2003; Samango-Sprouse and Suddaby 1997; Shillingford and Wernovsky 2004). Historically, the earliest studies found generally poorer psychiatric functioning in children and adolescents with CHD (Aurer et al. 1979; Green 1962; Myers-Vando et al. 1979). As studies progressed and began to account for confounding variables, such as coexistence of neurological or genetic disorders and age at assessment, many found that youngsters with CHD demonstrated overall healthy adjustment (DeMaso et al. 1990, 1991).

Limited research is available on the long-term impact of childhood heart disease into adulthood, although the available studies do report emotional vulnerabilities (Hulser et al. 2007; Miatton et al. 2007). One review has suggested that significant psychiatric difficulties surface in adolescence and generally only in patients with the most severe heart lesions (Karsdorp et al. 2007). In another review comparing the outcomes of the more advanced contemporary surgical interventions (after 1980) with outcomes determined prior to 1980, Spijkerboer et al. (2008) identified similar levels of behavioral and emotional problems.

The type or severity of pediatric heart disease does not readily predict a patient's emotional functioning (DeMaso 2004). For example, poorer psychological functioning was found to be accounted for primarily by IQ and central nervous system impairment as opposed to the heart lesion itself (De-Maso et al. 1990). Medical severity is less critical to successful adaptation than the quality of the mother-child relationship (DeMaso et al. 1991). In contrast, adolescents with cyanotic heart defects have been reported to have higher rates of depression and anxiety than those with acyanotic lesions (Spurkland et al. 1993).

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