Enhancing mental health in adults with congenital heart disease: comparison of depression and anxiety screening tools.

IF 3 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

European Journal of Cardio-Thoracic Surgery Pub Date : 2025-05-06 DOI:10.1093/ejcts/ezaf145

Anna-Lena Ehmann, Emily Schütte, Janina Semmler, Felix Berger, Ulrike M M Bauer, Katharina Schmitt, Constanze Pfitzer, Paul C Helm

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引用次数: 0

Abstract

Objectives: Individuals with congenital heart disease (CHD) face daily life limitations, increasing the risk of anxiety and depression. Diagnosing these disorders in adults with CHD (ACHD) remains challenging in the clinical routine, because physical symptoms can be misattributed to a patient's physical condition. Several screening instruments are available, and studies revealed that they can be used to diagnose varying numbers of people with clinically relevant symptoms. Therefore, we compared frequently used screening tools for depression and anxiety in ACHD in Germany.

Methods: Participants were recruited from the German National Register for Congenital Heart Defects. A total of 1486 patients aged 18 to 85 (Mage = 36.84; 60.8% female) were classified as simple, moderate or complex CHD. Self-reported measures of depression [Hospital Anxiety and Depression Scale (HADS-D); Patient Health Questionnaire-9 (PHQ-9)], anxiety [Hospital Anxiety and Depression Scale (HADS-A); Generalized Anxiety Disorder-7 (GAD-7)], psychotherapy utilization, secondary illnesses and sociodemographic characteristics, were recorded.

Results: The PHQ-9 recorded about 39% more patients with depressive symptoms compared to the HADS-D. The GAD-7 detected approximately 15% more patients with anxiety symptoms in comparison to the HADS-A. PHQ-9 and GAD-7 demonstrated higher sensitivity (89.6%/86.8%) but lower specificity (48.1%/53.5%) compared to the HADS-D/HADS-A (sensitivity: 56.3%/78.0%; specificity: 87.8%/67.2%). No significant differences were found between the CHD severity levels.

Conclusions: The screening tools we compared were used to diagnose a significantly different number of patients with depression or anxiety in ACHD. Because even mild symptoms have a significant impact on quality of life, using PHQ-9 and GAD-7 in clinical practice is recommended to minimize false negatives and ensure mental health in ACHD.

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改善成人先天性心脏病患者的心理健康：抑郁和焦虑筛查工具的比较

目的：先天性心脏病（CHD）患者面临日常生活限制，增加焦虑和抑郁的风险。诊断成人冠心病（ACHD）的这些疾病在临床常规中仍然具有挑战性，因为身体症状可能被错误地归因于患者的身体状况。有几种筛查工具可用，研究表明，它们可以诊断出不同数量的具有临床相关症状的人。因此，我们比较了德国ACHD患者常用的抑郁和焦虑筛查工具。方法：参与者从德国先天性心脏缺陷国家登记册中招募，年龄在18至85岁之间的1,486例患者(M年龄= 36.84；60.8%女性)分为单纯、中度和复杂冠心病。医院焦虑抑郁量表[HADS-D]；患者健康问卷-9 （PHQ-9）、焦虑（医院焦虑抑郁量表[HADS-A]）；记录广泛性焦虑障碍-7 （GAD-7）、心理治疗利用、继发疾病和社会人口学特征。结果：PHQ-9比HADS-D多记录39%的患者出现抑郁症状。与HADS-A相比，GAD-7检测到的焦虑症状患者约多15%。与HADS-D/HADS-A相比，PHQ-9和GAD-7的敏感性较高（89.6%/86.8%），但特异性较低（48.1%/53.5%）(敏感性：56.3%/78.0%；特异性:87.8% / 67.2%)。冠心病严重程度之间无显著差异。结论：我们比较了筛查工具，在ACHD中诊断出的抑郁或焦虑患者数量有显著差异。由于即使是轻微的症状也会对生活质量产生重大影响，建议在临床实践中使用PHQ-9和GAD-7，以减少假阴性，确保ACHD患者的心理健康。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Cardio-Thoracic Surgery 医学-呼吸系统

CiteScore

5.60

自引率

11.80%

发文量

564

审稿时长

2 months

期刊介绍： The primary aim of the European Journal of Cardio-Thoracic Surgery is to provide a medium for the publication of high-quality original scientific reports documenting progress in cardiac and thoracic surgery. The journal publishes reports of significant clinical and experimental advances related to surgery of the heart, the great vessels and the chest. The European Journal of Cardio-Thoracic Surgery is an international journal and accepts submissions from all regions. The journal is supported by a number of leading European societies.