Abstract 4147236: Healing Hearts Mending Minds: Battling Anxiety and Depression in adults with congenital heart disease.

Background/Introduction: Adults with congenital heart disease have higher rates of anxiety, depression, and suicide, compared to those without congenital heart disease. A variety of factors contribute to psychological distress among adults with CHD, including functional impairment, neurocognitive deficits, the increasing concerns for reinterventions, body image due to surgical scars or body insecurity. However, screening and targeted treatment is still lacking. Methods/Approach: 96 unique patients were seen in ACHD clinic. Each was screened for anxiety and depression using the PHQ-4. Based on the results and clinical findings, 1 of 4 clinical pathways were pursued: 1 negative screening; no consult with a psychologist was recommended; 2 positive PHQ-4 with telehealth follow-up with an in-practice psychologist; 3 PHQ-4 positive with an in-practice psychologist consult during their outpatient visit; 4 already established relationship with a psychologist. Results/Data: Of the unique 96 patients seen in ACHD clinic 6 were excluded for severe developmental delays. Of the remaining 90 patients, 7% (n = 6) had an established relationship with a psychologist. The 84 that did not have an established relationship with a psychologist were screened for anxiety and depression. 49%, ( n = 44) were either seen in clinic by the psychologists and 22%, (n=20) followed up with an outpatient visit. The remaining 22% (n = 20) were screened and had a negative phq-4 with no clinically significant signs of anxiety or depression at that visit. Conclusions: Adults living with CHD have and will continue to encounter unique challenges that extend beyond the physical realm, often grappling with psychological distress that affects their overall well-being and quality of life. While depression has been a focal point in general cardiac research, elevated anxiety levels are equally significant and warrant attention. Within this study, anxiety and depression requiring mental health follow-up was underdiagnosed and undertreated in 76% of the population. Underpinning the need for routine screening for psychological and QOL impairments, as well as ntegration of mental health professionals within ACHD programs.