Neurodevelopmental Outcome, Psychological Adjustment, and Quality of Life in Adolescents With Congenital Heart Disease

Dev Med Child Neurol. 2013 Dec;55(12):1143-9. doi: 10.1111/dmcn.12242. Epub 2013 Aug 13.

Abstract

Aim: The aim of this study was to examine neurodevelopment, psychological adjustment, and health-related quality of life (HRQoL) in adolescents after bypass surgery for congenital heart disease (CHD) during early childhood.

Method: Fifty-nine adolescents (34 females, 25 males) with CHD were examined at a median age of 13 years 8 months (range 11 y 5 mo-16 y 11 mo). Outcome was assessed with the Wechsler Intelligence Scale for Children, (fourth edition); the Beery Test of Visual-Motor Integration; the Rey-Osterrieth Complex Figure Test; the Zurich Neuromotor Assessment; the Strengths and Difficulties Questionnaire; and the KIDSCREEN questionnaires. Results were compared with those of 40 age- and sex-matched healthy comparison individuals.

Results: Outcome with regard to full-scale IQ, perceptual reasoning, and the working memory scale was poorer in patients with CHD than in the comparison group (all p ≤ 0.001). Visual perception, visuomotor integration (p ≤ 0.001), and executive functions (Rey figure copy: p=0.05) were also affected. Patients with CHD also had lower scores on all motor domains (p < 0.02) except static balance. Psychological adjustment was affected only in the 'peer relationship' domain (p=0.05). Quality of life was similar to that of typically developing peers.

Interpretation: Adolescents with CHD may manifest persistent cognitive and motor impairments, while psychological adjustment and self-reported HRQoL are mostly typical. Thus, long-term neurodevelopmental evaluations are necessary to provide early educational and therapeutic support.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological / physiology*
  • Adolescent
  • Child
  • Cognition Disorders / etiology*
  • Concept Formation / physiology
  • Developmental Disabilities / etiology*
  • Executive Function / physiology
  • Female
  • Heart Defects, Congenital / complications*
  • Heart Defects, Congenital / psychology*
  • Humans
  • Male
  • Memory, Short-Term / physiology
  • Neuropsychological Tests
  • Outcome Assessment, Health Care
  • Quality of Life*
  • Surveys and Questionnaires
  • Wechsler Scales