Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis

J Pediatr Psychol. 2007 Jun;32(5):527-41. doi: 10.1093/jpepsy/jsl047. Epub 2006 Dec 20.


Objective: Findings in the literature are inconsistent on the impact of congenital heart disease (CHD) on the psychological and cognitive functioning of children and adolescents. The aim of the present study was to systematically review this empirical body of literature.

Methods: We conducted a meta-analysis to review studies on behavior problems and cognitive functioning in CHD.

Results: Only older children and adolescents with CHD displayed an increased risk of overall, internalizing, and to a lesser extent externalizing behavior problems. In addition, patients with severe CHD exhibited lower cognitive functioning than patients with less severe CHD, specifically with respect to performance intelligence. Moreover, decreased cognitive functioning remained relatively stable across different age groups.

Conclusions: Children with severe heart disease may benefit from interventions specifically targeting perceptual organizational abilities, such as visual-spatial abilities. Moreover, older children and adolescents with CHD may benefit from psychological interventions reducing anxiety symptoms and depression.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety / diagnosis
  • Anxiety / etiology*
  • Anxiety / psychology*
  • Child
  • Child, Preschool
  • Chronic Disease / psychology
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology*
  • Female
  • Heart Defects, Congenital / epidemiology*
  • Heart Defects, Congenital / psychology*
  • Humans
  • Male
  • Neuropsychological Tests
  • Severity of Illness Index