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Electronic Mental Health Screening in a Pediatric Heart Failure and Transplant Clinic

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Abstract

Adults with heart failure and transplant are at increased risk for psychiatric comorbidities. The prevalence and impact of psychiatric comorbidities have not been well studied in pediatric heart failure and transplant. This quality improvement project sought to evaluate the feasibility of utilizing electronic mental health screening measures during pediatric heart failure and transplant clinics and to explore the prevalence and severity of self-reported depressive, anxiety, and suicidal ideation symptoms. Patients aged 11 years and older who presented to a pediatric heart failure and transplant clinic were administered the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). Medical chart review and a survey were used to examine additional variables of interest. There were no significant differences in moderate and severe mental health symptoms between gender, medical diagnoses, or those with recent hospitalizations. Pediatric patients with heart failure or transplant reported higher prevalence of anxiety and depressive symptoms, and similar suicidal ideation compared to the general adolescent population. Moreover, rates of depression and anxiety symptoms as well as suicidal ideation were comparable to pediatric patients with diabetes, lupus, inflammatory bowel disease, and cystic fibrosis. Results suggest electronic mental health screening is feasible for use during outpatient cardiology clinic visits and provides valuable mental health information.

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Acknowledgements

The authors acknowledge Sara Levinson, MPH, MSLOC for her assistance in proof-reading the article and offering comments and suggestions. This quality improvement project was funded by the Center for Depression Research and Clinical Care at UT Southwestern Medical Center. The authors also acknowledge the time and dedication of the heart failure and heart transplant clinic coordinators in completing weekly mental health screenings.

Funding

Grant support provided by the Center for Depression Research and Clinical Care at UT Southwestern Medical Center.

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Authors and Affiliations

  1. Department of Cardiology, Children’s Health – Children’s Medical Center, 1935 Medical District Drive, Dallas, TX, 75235, USA

    Corinne M. Anton

  2. Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Corinne M. Anton & Kelli N. Triplett

  3. Department of Psychology and Psychiatry, Children’s Health – Children’s Medical Center, Dallas, TX, USA

    Morgan B. Drake

  4. Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Ryan J. Butts

  5. Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Thi Cao, Afsaneh Rezaeizadeh & Madhukar H. Trivedi

  6. Department of Solid Organ Transplant, Children’s Health – Children’s Medical Center, Dallas, TX, USA

    Kelli N. Triplett

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  1. Corinne M. Anton
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Contributions

Drs. Corinne Anton and Kelli Triplett contributed to study design, data collection, data analysis, and manuscript preparation. Dr. Morgan Drake contributed to data entry and manuscript preparation. Dr. Ryan Butts contributed to statistical analysis and manuscript preparation. Afsaneh Rezaeizadeh, Thi Cao, and Dr. Madhukar Trivedi contributed to critical review of the manuscript.

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Correspondence to Corinne M. Anton.

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Conflict of interest

Drs. Corinne M. Anton, Morgan B. Drake, Ryan J. Butts, and Kelli N. Triplett, as well as Thi Cao, BS and Afsaneh Rezaeizadeh, MSW, RN do not report any conflicts of interest. Dr. Trivedi does not have any conflicts of interest to report in relation to the submitted work. Dr. Trivedi does report financial activities outside of the submitted work enclosed. The VitalSign6 program was funded by the Center for Depression Research and Clinical Care. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding organization. The Intellectual Property of VitalSign6 belongs to the University of Texas Southwestern Medical Center (Dr. Trivedi). All proprietary tools and methods used in VitalSign6 are owned by the University of Texas Southwestern Medical Center.

Human and Animal Rights/Informed Consent

The project was reviewed by the Institutional Review Board of the University of Texas Southwestern Medical Center and deemed exempt from approval for human subjects research as mental health screenings were implemented as part of standard patient care.

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Anton, C.M., Drake, M.B., Butts, R.J. et al. Electronic Mental Health Screening in a Pediatric Heart Failure and Transplant Clinic. J Clin Psychol Med Settings 28, 815–825 (2021). https://doi.org/10.1007/s10880-021-09770-8

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