Mental Health of Children with Fontan Circulation: Associations with Maternal Psychopathology and Parenting Behavior

Abstract Children with Fontan circulation face substantial long-term psychosocial challenges. Parental mental health and parenting behavior are known to influence psychosocial outcomes in children with congenital heart disease (CHD), yet data specific for Fontan families are scarce. This cross-sectional controlled study examined child psychopathology in relation to maternal psychopathology and parenting behavior. 31 mothers and their children with Fontan circulation (aged 4–16 years) were compared with a sex-, age- and socioeconomic status (SES)- matched control group. Standardized maternal self-report questionnaires assessed child psychopathology, maternal psychopathology, and parenting behavior. Children with Fontan circulation showed significantly higher psychopathology than controls ( F (1,58) = 6.38, p = .014, η p ² = 0.10). No group differences were found in maternal psychopathology or parenting behavior (all p > .24). No Group × Moderator interaction effects emerged (all p > .35). Significant main effects were observed for maternal total psychopathology, anxiety, and depression ( F (1,58) = 13.10, p < .001, η p ² = 0.19; F (1,58) = 9.94, p = .003, η p ² = 0.15; F (1,58) = 11.00, p = .002, η p ²= 0.16), and inconsistent parenting behavior ( F (1,58) = 19.20, p < .001, η p ² = 0.26), associated with higher child psychopathology across groups, underscoring the need for family-focused support in the Fontan population.