Abstract 197 Post-traumatic stress in adults with congenital heart disease: an under-recognized comorbidity?

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02087-y
Post-traumatic stress in adults with congenital heart disease: an under-recognized comorbidity?
A. Freiberger¹, C. Richter¹, J. Beckmann², M. Huber¹, S. Freilinger¹, H. Kaemmerer¹, P. Ewert¹, C. Röhrich³, N. Kohls³, P. Henningsen⁴, C. Allwang⁴, C. Andonian¹
¹Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, München; ²Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, München; ³Hochschule für angewandte Wissenschaften Coburg, Coburg; ⁴Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum Recht der Isar, München;
Background: Due to medical advances in treatment and care and improved survival of patients with congenital heart disease (CHD), their psychosocial situation has recently received increasing attention. The extent to which treatment- or disease-related stressors affect mental health and, in particular, the development of post-traumatic stress disorder (PTSD) has not been sufficiently examined yet. The aim of the present study is to determine the prevalence of PTSD symptoms in adults with CHD (ACHD) and to identify associated medical and psychosocial risk factors. Methods: In total, 120 ACHD were recruited from November 2021 to May 2022 at a tertiary centre specialized for ACHD in a retrospective cross-sectional design. Using validated and standardized questionnaires, data were collected on sociodemographic information, general health, symptoms of PTSD, anxiety and depression, and social support. Results were obtained using descriptive analyses, correlations, and regression models. Results: Overall, 24% (mean age: 35.14 ±10.66 years, 48.3% female) of enrolled patients met criteria for elevated PTSD scores specifically related to their CHD or treatment. Associated risk factors included pre-existing mental problems (40.5%), as well as the extent of emotional distress in the context of cardiac disease. The correlation with CHD severity, the number of interventions or the age at most recent surgery did not reach statistical significance. Feelings of helplessness and existential anxiety in the context of CHD emerged as risk factors for PTSD. Protective factors included perceived immediate and extended social support during childhood. Conclusion: Despite profound adverse effects of PTSD on cardiovascular health and an elevated prevalence in ACHD, PTSD is largely overlooked in the medical management of CHD patients. The increased awareness of PTSD associated with CHD has created a need for attention and thus makes it necessary to reflect upon psychocardiological elements as an integral part of multidisciplinary approach to the treatment of patients with CHD.
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