Congenital heart defects and developmental and other psychiatric disorders: a Danish nationwide cohort study

We examined the risk of psychiatric in-patient admissions and out-patient visits among Danish patients with congenital heart defects (CHD).

Using the Danish National Registry of Patients, we identified CHD patients born January 1, 1977, to January 1, 2002. For each patient, we randomly selected 10 population-comparison cohort members from the Danish Civil Registration System, matched by sex and birth year. We computed cumulative risk and hazard ratios (HRs) of time to first psychiatric in-patient admission or out-patient visit identified in the Danish Psychiatric Central Registry and adjusted for parents' educational level and parents' psychiatric morbidity. We identified 6927 CHD patients. At 15 years of age, the cumulative risk of psychiatric admissions or out-patient visits was 5.9% (95% confidence interval [CI], 5.2%-6.6%) among CHD patients. The HRs for CHD patients and comparison cohort members aged 0 to 14 years were 1.8 (95% CI: 1.5-2.1) for males and 2.5 (95% CI: 2.0-3.1) for females. For patients aged 15 to 30 years, the HRs were 1.6 (95% CI: 1.2-2.0) for males and 1.0 (95% CI: 0.8-1.3) for females. Congenital heart defect patients, both with and without invasive therapeutic interventions or extracardiac defects or syndromes, had a higher risk of psychiatric in-patient admissions or out-patient visits than comparison cohort members. After restriction of the comparison cohort to patients with diabetes mellitus or asthma (n=2554), the HR was 1.41 (95% CI: 1.07-1.85) for patients aged 0 to 14 years and 0.70 (95% CI: 0.52-0.94) for patients aged 15 to 30 years.

Congenital heart disease patients with or without invasive therapeutic interventions are at increased risk of developmental and other psychiatric disorders, which seem to develop earlier than in patients with diabetes mellitus or asthma.