Anxiety and Depression Symptoms in Children and Adolescents with Congenital Heart Disease

Background: Congenital heart disease (CHD) is associated with an increased risk of anxiety and depression in adults. However, little is known about the mental health of children and adolescents with CHD. The aim of this study was to assess differences in anxiety and depression symptoms between children and adolescents with CHD and healthy controls. Methods: A total of 232 children and adolescents (age 7–18 years; mean age 13.5 ± 2.7 years, 50.9% female) were enrolled, consisting of 116 patients with CHD and 116 age- and sex-matched healthy controls. Participants were recruited during routine medical examinations at the German Heart Center and Munich schools, respectively. The Beck Anxiety Inventory (BAI) and the Depression Inventory for Youth (BDI-Y) were used to assess anxiety and depression symptoms. Results: The CHD cohort included patients with right heart obstruction (11.2%), left heart obstruction (19.8%), isolated shunts (15.5%), transposition of the great arteries (14.7%), univentricular heart (14.7%), and other defects (24.1%). According to published cut-off values, at least a mild form of anxiety was present in 46.5% CHD patients. However, no significant differences were observed between the CHD group and healthy controls in either the BDI-Y score (CHD: 7.9 ± 7.7 vs. controls: 8.6 ± 8.5; p = 0.569) or the BAI score (CHD: 9.3 ± 8.6 vs. controls: 9.3 ± 10.3; p = 0.429). The complexity of the heart defect was not associated with BAI scores (simple: 5.9 ± 5.7; moderate: 11.1 ± 8.1; complex: 9.3 ± 9.0; p = 0.073) or BDI-Y scores (simple: 7.4 ± 7.5; moderate: 9.0 ± 7.1; complex: 7.0 ± 7.7; p = 0.453). No significant differences in BAI (p = 0.141) or BDI-Y (p = 0.326) scores were found by type of heart defect. Conclusions: Children and adolescents with CHD did not exhibit significantly higher levels of depression or anxiety symptoms compared to healthy controls. Nevertheless, given the increased psychological risk observed in adults with CHD, ongoing mental health monitoring remains important to enable early identification and timely intervention. Further research, particularly through longitudinal studies, is needed to monitor mental health trajectories over time and to identify early predictors of psychological vulnerability in this population.