Psychiatric Disorders and Function in Adolescents with d-Transposition of the Great Arteries

• Published in: The Journal of pediatrics Vol. 165; no. 4; pp. 760 - 766
• Main Authors: DeMaso, David R., MD, Labella, Madelyn, BA, Taylor, George Alexander, BA, Forbes, Peter W., MA, Stopp, Christian, MS, Bellinger, David C., PhD, MSc, Rivkin, Michael J., MD, Wypij, David, PhD, Newburger, Jane W., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2014
• Subjects: Adolescent; Behavior; Brain - pathology; Case-Control Studies; Child; Cognition; Cognition Disorders; Cohort Studies; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Mental Disorders - complications; Mental Disorders - physiopathology; Mental Disorders - psychology; Pediatrics; Prevalence; Risk Factors; Stress Disorders, Post-Traumatic - complications; Stress, Psychological; Transposition of Great Vessels - complications; Transposition of Great Vessels - physiopathology; Transposition of Great Vessels - psychology; ADHD; Children's Depression Inventory; DSM-IV; Child Stress Disorders Checklist; MRI; CDI; CGAS; Post-Traumatic Stress Diagnostic Scale; Attention-deficit/hyperactivity disorder; Parenting Stress Index; d-TGA; Brief Psychiatric Rating Scale for Children; ASO; PDS; Boston Circulatory Arrest Study; PSI; BPRS-C; BCAS; d-Transposition of the great arteries; Children's Global Assessment Scale; Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version; CSDC; Arterial switch operation; Magnetic resonance imaging; Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; K-SADS-PL
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2014.06.029

Objective To compare adolescents with d-transposition of the great arteries (d-TGA) with healthy adolescents with respect to prevalence of psychiatric disorders and global psychosocial functioning. Study design Subjects, consisting of 139 adolescents with d-TGA (16.1 ± 0.5 years) and 61 healthy adolescents (15.3 ± 1.1 years) without known risk factors for brain disorders, underwent a battery of assessments, including semistructured psychiatric interviews; self-report measures of depressive, anxiety, and disruptive behavior symptoms; and brain magnetic resonance imaging. Previous cognitive functioning and parental stress assessments at age 8 as well as parental post-traumatic stress at age 16 years were explored as potential risk factors predictive of overall psychiatric functioning. Results Compared with healthy adolescents, adolescents with d-TGA had higher lifetime prevalence of structured interview-derived attention-deficit/hyperactivity disorder (19% vs 7%, P  = .03), along with reduced global psychosocial functioning (80.6 ± 11.2 vs 87.2 ± 7.1, P  < .001) as well as significant increases in self-reported depressive ( P  = .01), anxiety ( P  = .02), and disruptive behavior symptoms (parent P  < .001 and adolescent P  = .03). Nevertheless, these youth scored in the nonclinical range on all self-report measures. Level of global psychosocial functioning was positively related to cognitive functioning ( P  < .001) and negatively related to parental stress ( P  = .008). Conclusions Although adolescents with d-TGA demonstrate significant resilience to known neuropsychological and academic deficits, they show increased rates of attention-deficit/hyperactivity disorder and reduced psychosocial functioning. Impaired cognitive functioning and parental stress at younger age emerged as significant risk factors for psychiatric impairment.