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Mental, behavioural, and developmental disorders among U.S. Children with and without heart conditions, 2016-2021

Amanda N Dorsey1,2, Karrie F Downing2, Melissa Danielson2

  • 1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.

Cardiology in the Young
|August 20, 2025
PubMed

Insights

Children with heart conditions have significantly higher rates of mental, behavioral, and developmental disorders. Anxiety, ADHD, and learning disabilities are most common, often linked to adverse childhood experiences.

Area of Science:

  • Pediatric Cardiology
  • Developmental Pediatrics
  • Child Psychology

Background:

  • Children with heart conditions, including congenital heart defects (CHDs), face increased risks for neurodevelopmental and psychosocial challenges.
  • Understanding the prevalence of mental, behavioral, and developmental disorders in this population is crucial for early intervention.

Purpose of the Study:

  • To compare the national prevalence of mental, behavioral, and developmental disorders in children based on heart condition status.
  • To identify characteristics associated with these disorders among children with heart conditions.

Main Methods:

  • Analysis of nationally representative data from the National Survey of Children's Health (2016-2021) for U.S. children aged 6-17 years (excluding those with Down syndrome).
  • Caregiver-reported data on diagnosed mental, behavioral, and developmental disorders.
  • Logistic regression was used to compare prevalence and identify associated factors.

Main Results:

  • Children with heart conditions had a 42% prevalence of examined disorders, compared to 23% in children without heart conditions (APR=1.8).
  • All analyzed disorders were more prevalent in children with heart conditions, with anxiety (22.1%), ADHD (20.4%), and learning disabilities (19.6%) being most common.
  • Among children with heart conditions, disorders were consistently associated with a higher number of adverse childhood experiences.

Conclusions:

  • Findings underscore the importance of clinical guidelines for neurodevelopmental and mental health screening in children with heart conditions.
  • The study provides a national baseline for evaluating the implementation of these crucial guidelines.
Abstract

Keywords:
Paediatric cardiologyheart conditionsneurodevelopment

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