Emotional and behavioral problems in children with dilated cardiomyopathy.
Malindi van der Mheen, Marijke H van der Meulen, Susanna L den Boer and 11 others
PMID 31552760WHAT IT FOUND
Parents reported more anxiety, depression, and physical complaints in 6-18-year-olds with dilated cardiomyopathy than in peers.
In toddlers, physical complaints were higher and acting-out problems lower. Anxiety and depression did not predict death or transplant.
Key findings
01In 6- to 18-year-old children with dilated cardiomyopathy, parents reported more borderline or clinical anxiety, depressive, internalizing, and somatic problems than in general population norms.
02In 1.5- to 5-year-old children with dilated cardiomyopathy, parents reported more borderline or clinical somatic complaints and fewer externalizing problems than in general population norms.
03Parent-reported anxiety and depressive problems did not significantly predict death or cardiac transplantation, while heart failure severity did.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The emotional and behavioral problems were reported by parents, not by the children themselves, so a child's anxiety or depression may be missed or described differently. The prediction analysis had only 11 endpoint events, so it cannot reliably rule out a link between anxiety or depression and death or transplant. The study compared children with dilated cardiomyopathy with general population norms rather than a healthy control group recruited in the same way. Most children were studied months after diagnosis, and children who died or recovered soon after diagnosis were likely underrepresented, so results apply mainly to chronic heart failure. Father and mother reports were combined, and most questionnaires were completed by mothers, which may bias the results.
The easy way to misread this
Do not conclude that treating anxiety or depression in children with dilated cardiomyopathy will lower the risk of death or cardiac transplantation. Anxiety and depressive problems did not significantly predict that endpoint, and the prediction analysis had only 11 events.