Psychological interventions for people affected by childhood-onset heart disease: A systematic review.

Abstract

Objective: Guidelines recommend psychological intervention for children, adolescents, and adults with childhood-onset heart disease and their families, yet a comprehensive review of interventions is lacking. We aimed to determine the efficacy of psychological interventions for this population. Method: We searched 6 electronic databases until August, 2017 for English-language, controlled trials of psychological interventions for children, adolescents, or adults with congenital heart disease, inherited arrhythmias, or cardiomyopathies, or their family members. Outcomes of interest included: anxiety, depression, psychological stress and distress, health-related quality of life, coping and adjustment, developmental outcomes, physical health, and parent and family outcomes. Results: Of 7,660 identified articles, 11 articles reporting on 9 unique interventions met inclusion criteria. Four interventions included adolescents or adults with congenital heart disease, 2 of which also included individuals with cardiomyopathies, valvular heart conditions, or inherited arrhythmias. Five interventions targeted parents, predominantly mothers, of children with congenital heart disease. Clinical and methodological diversity was observed across trials. Parent-focused interventions demonstrated some improvements in maternal mental health, including anxiety and worry, coping, and family functioning. Evidence for the efficacy of interventions for adolescents and adults was limited. Most trials (8/9) were at "high" or "serious" risk of bias. Conclusions: Despite an established evidence-base for psychological interventions in other chronic illness populations, evidence of efficacy for children and adults with childhood-onset heart disease and their families was limited. Interventions using conceptual frameworks tested in methodologically robust trials are needed to enhance the provision of mental health care for people of all ages with childhoodonset heart disease.

Mental Health Disorders in Children With Congenital Heart Disease

“…Two efficacious interventions for youth with CHD have been described, one focusing on disease management strategies and the other on relaxation and stress management. [48][49][50] Parent management training and cognitive behavioral therapy (CBT) may effectively treat anxiety and depressive symptoms. [51][52][53] There are emerging data to support CBT with the addition of pharmacotherapy in adults, with promising preliminary results revealing a reduction in both anxiety and depressive symptoms.…”

Management of People With a Fontan Circulation: a Cardiac Society of Australia and New Zealand Position statement

“…At the time of writing, there were no published data on the efficacy of psychological or neurodevelopmental interventions developed specifically for people with a Fontan circulation [162,163]. However, recommendations can be drawn from evidence accumulated for the broader population with CHD [138,163], as well as those with other childhood critical and chronic illnesses, and illness more broadly.…”

“…At the time of writing, there were no published data on the efficacy of psychological or neurodevelopmental interventions developed specifically for people with a Fontan circulation [162,163]. However, recommendations can be drawn from evidence accumulated for the broader population with CHD [138,163], as well as those with other childhood critical and chronic illnesses, and illness more broadly. Recognition of, and early intervention for, psychological and neurocognitive effects are vital to ensuring the best possible quality of life for people with a Fontan circulation and their families [164,165].…”

Mental health care for parents of babies with congenital heart disease during intensive care unit admission: Systematic review and statement of best practice

“…For the purposes of this review, 'psychological intervention' was defined as any intervention based on: (a) specific psychological principles, skills or techniques, (b) a psychological theory, or (c) input from a mental health professional and was delivered in isolation or in conjunction with other medical, practical or educational components. 68 Examples include psycho-education, cognitive-behavioral therapy, mindfulnessbased stress reduction, and psychoanalytic psychotherapy. Control arms could include any active or attentional placebo, waitlist control, or standard care conditions.…”