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Comorbidity as a mediator of depression in adults with congenital heart disease: A population-based cohort study

Hsiao-Ling Yang1,2, Nien-Tzu Chang1,2, Jou-Kou Wang3

  • 1School of Nursing, College of Medicine, National Taiwan University, Taiwan.

European Journal of Cardiovascular Nursing
|May 21, 2020
PubMed

Insights

Adults with congenital heart disease (CHD) have a higher risk of depression. Physical conditions like coronary artery disease significantly mediate this link, highlighting the need for integrated care.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • The growing population of adults with congenital heart disease (CHD) experiences numerous physical and psychological health challenges.
  • The interplay between CHD, acquired physical comorbidities, and mental health remains under-researched.

Purpose of the Study:

  • To examine the association between adult congenital heart disease and depression.
  • To determine if physical comorbidities mediate the relationship between adult congenital heart disease and depression.

Main Methods:

  • A retrospective cohort study utilizing Taiwan's National Health Insurance Research Database (2010-2013).
  • Mediation analysis in survival data was employed to assess mediated effects.
  • Analyses adjusted for age, sex, residence, and propensity scores.

Main Results:

  • Adult congenital heart disease patients showed a significantly higher risk of depression (aHR=1.43) compared to controls.
  • Complex congenital heart disease patients had an even higher risk (aHR=1.48).
  • Coronary artery disease (35.5%) and chronic obstructive pulmonary disease (12.9%) significantly mediated the association between adult congenital heart disease and depression.

Conclusions:

  • Preventing acquired psychological and physical conditions is crucial for adults with CHD.
  • Coronary artery disease acts as a significant mediator, particularly for those with complex congenital heart disease, linking it to depression.
Abstract

Keywords:
Congenital heart diseasecomorbiditycoronary artery diseasedepressionmediatorpopulation-based cohort study

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