231. ACHD: Congenital Heart Disease and Psychosocial Wellbeing with Dr. Adrienne Kovacs and Dr. Lauren Lastinger

Published: Sept. 12, 2022, 5:20 a.m.

CardioNerds Dr. Josh Saef, Dan Ambinder, join Dr. Jim Kimber and interview experts Dr. Adrienne Kovacs, and Dr. Lauren Lastinger and discuss behavioral health needs and psychosocial wellbeing in the congenital heart disease population. In this episode, our experts tackle issues surrounding mental and behavioral health including anxiety/depression, ADHD, neurodevelopmental disabilities, psychosocial challenges, stressors unique to patients with ACHD and their families, and how the healthcare system can better optimize mental health care for the CHD patient population. Audio editing by\xa0CardioNerds Academy Intern,\xa0Pace Wetstein.\n\n\n\n\n\nThe\xa0CardioNerds Adult Congenital Heart Disease (ACHD) series\xa0provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs,\xa0Dr. Josh Saef,\xa0Dr. Agnes Koczo, and\xa0Dr. Dan Clark. \n\n\n\nThe CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more\n\n\n\nDisclosures: None\n\n\n\n\n\nPearls \u2022 Notes \u2022 References \u2022 Guest Profiles \u2022 Production Team\n\n\n\n\n\n\n\n\n\n\n\nCardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll\n\n\n\n\n\nCardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron!\n\n\n\n\n\n\n\n\n\nPearls - Congenital Heart Disease and Psychosocial Wellbeing \n\n\n\nAmong patients with congenital heart disease, symptoms of anxiety are more common than symptoms of depression. \u201cHeart-focused anxiety\u201d relates to symptoms attributable to a heart condition including fear of appointments, surgery, or health-uncertainty. It is important to differentiate this from generalized anxiety.Predictors of depression and anxiety include patient-reported physical health status. Defect severity (mild, moderate, great complexity) and physician-diagnosed NYHA class were NOT associated with rates of depression/anxiety [2].Despite CHD, patient self-reported Quality of Life (QoL) is relatively high. Predictors of decreased QoL include older age, lack of employment, never having married, and worse self-reported NYHA functional classImportant treatment strategies include: education for patients and caregivers, early identification and referral to mental health providers, incorporation of providers into CHD teams, and encouraging physical activity and peer-interaction.\n\n\n\nShow notes - Congenital Heart Disease and Psychosocial Wellbeing \n\n\n\nNotes (developed by Dr. Jim Kimber)\n\n\n\nMental Health Terminology:\n\n\n\nAdults with CHD face the same mental health challenges as people who don\u2019t have a heart condition. Symptoms of depression and anxiety are the most common: Approximately 1/4 - 1/3 of CHD patients will struggle with clinically significant depression or anxiety at any one point. Up to \xbd will meet lifetime diagnostic criteria for these conditions\n\n\n\nMood and anxiety disorders differ in that they have separate diagnostic criteria. Importantly, research often uses self-reported symptoms, rather than patients who have formally met diagnostic criteria.\n\n\n\nHistorically, the focus has been on depression.\xa0 However, elevated symptoms of anxiety are much more common than elevated symptoms of depression.\n\n\n\nIt is important to make the distinction between \u201cGeneralized Anxiety,\u201d and \u201cHeart-Focused Anxiety.\u201dHeart-Focused Anxiety: symptoms of anxiety directly related to having a heart condition, such as fear of appointments / worry about a decline in health status, getting an ICD, preparing for surgery, transplants, or having a shortened life expectancy, etc. This may also include a significant component of he...