Psychological distress in parents of children with severe congenital heart disease: the impact of prenatal versus postnatal diagnosis

Abstract

Objective: The purpose of the study was to evaluate coping and psychological functioning of parents of children prenatally or postnatally diagnosed with congenital heart disease.Study Design: Parents of 10 infants prenatally diagnosed by fetal echocardiogram and 7 infants postnatally diagnosed with severe congenital heart disease completed the Brief Symptom Inventory (BSI) at the time of diagnosis, at the time of birth and 6 months after birth. Prenatal and postnatal groups were compared to each other and to BSI norms.Result: Although both groups scored higher than test norms at the time of diagnosis, they did not differ significantly from each other. Six months after birth, the postnatal group scores did not differ from test norms, but the prenatal group scores were still significantly higher than test norms. The severity of the child's heart lesion at diagnosis was related to parental distress levels; parents with children with more severe lesions had higher BSI scores. Conclusion:Results suggest the need to provide parents with psychological support, regardless of the timing of diagnosis. Parents of children with more severe lesions may be at risk for higher levels of psychological distress, particularly over time.

Patterns of parental emotional reactions after a pre- or postnatal diagnosis of a congenital anomaly

“…Additionally, despite some variability in the time elapsed since the diagnosis until the delivery of questionnaires, our results on psychological distress after a DCA are similar to previous studies with assessments at one week (Brosig et al, 2007), one month (Doherty et al, 2009), and 8-10 weeks (Brisch et al, 2003) after the diagnosis. As such, we consider that this variability does not significantly compromise our results.…”

“…However, the existent studies showed that adjustment in the early post-diagnosis stage predicted parental adjustment in later evaluations (e.g., six months after the birth of the infant, Skari et al, 2006). Furthermore, even where there was a decrease in the levels of psychopathological symptoms over time, they tended to keep significantly higher than the normative values (Brisch et al, 2003;Brosig et al, 2007). Similar results were found in a longitudinal study on the impact of a perinatal loss in maternal psychopathological symptoms.…”

“…For example, approximately one month after the DCA, Doherty et al (2009) found clinically significant levels of psychopathological symptoms in 33% of mothers and 18% of fathers; another study found that, approximately one week after the diagnosis, parents of children with congenital heart disease experienced higher levels of distress when compared to norms. Unlike the first study, this study has found no gender differences in the proportion of clinically significant psychopathological symptoms (Brosig, Whitstone, Frommelt, Frisbee, & Leuthner, 2007).…”

Parental Psychological Distress and Confidence After an Infant’s Birth: The Role of Attachment Representations in Parents of Infants with Congenital Anomalies and Parents of Healthy Infants

“…However, other studies did not find gender differences in levels of psychological distress (Brosig et al, 2007).…”

“…Skari et al (2006) found that six weeks after birth, parents of infants with a surgically correctable CA had higher levels of psychological distress than parents of healthy infants. Comparing their data to normative data, Brosig, Whitstone, Frommelt, Frisbee, and Leuthner (2007) found that parents of children with congenital heart disease had higher levels of psychological distress at the time of their child's birth. Aite et al (2003) also found higher levels of anxiety in parents of infants with a surgically correctable CA.…”