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Increased prevalence of inattention-related symptoms in a large cohort of patients with congenital heart disease

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Abstract

The objective of this study is to assess the prevalence and risk factors for attention-deficit hyperactivity disorder (ADHD) in a large cohort of patients with congenital heart disease (CHD). Patients (n = 695) with CHD who were aged 6–15 years and visited the outpatient clinics in our hospital from June 2015 to May 2017 were enrolled. Their medical records were collected, and the Chinese version of the Swanson, Nolan, and Pelham rating scale (SNAP-IVc) and a questionnaire about neuropsychiatric care-seeking behavior were completed by parents and counselors. Of the 695 patients, the overall prevalence of ADHD was 12.4%, including 3.2% for the combined subtype, 6.8% for the inattentive-predominant subtype, and 2.4% for the hyperactivity/impulsive-predominant subtype. Only the inattention-predominant subtype was significantly more prevalent than in the general population. The prevalence of the inattention-predominant subtype was highest in the patients with cyanotic CHD, high severity index, and in those who had received surgery or cardiopulmonary bypass. Multivariate regression analysis indicated that the risk factors for inattention-related symptoms included postoperative seizure and previous cardiopulmonary bypass (odds ratio: 3.22 and 3.82; P = 0.027 and < 0.001, respectively). Only 58.7% of the patients with probable ADHD ever sought neuropsychiatric care, and only 27% regularly attended neuropsychiatric clinics. The inattention-predominant subtype of ADHD was more prevalent in our CHD patients, especially in those with cyanotic CHD, higher disease severity index, and in those who had undergone a surgical intervention. The percentage of patients receiving regular neuropsychiatric clinic follow-up was low.

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Funding

Cardiac Children Foundation, Taiwan, CCFT-2015-02 and National Health Research Institutes, Taiwan, PH-106-SP-15.

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Author notes

  1. Shuenn-Nan Chiu and Wen-Chin Weng contributed equally to this work and served as corresponding authors.

Authors and Affiliations

  1. Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei, Taiwan

    Chia-Ching Wang

  2. Department of Pediatrics, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan

    Wen-Chin Weng, Mei-Hwan Wu, Jou-Kou Wang, Chun-Wei Lu, Ming-Tai Lin, Chun-An Chen & Shuenn-Nan Chiu

  3. Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan

    Ling-Yin Chang

  4. Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan

    Hsing-Yi Chang

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  1. Chia-Ching Wang
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Correspondence to Wen-Chin Weng or Shuenn-Nan Chiu.

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Wang, CC., Weng, WC., Chang, LY. et al. Increased prevalence of inattention-related symptoms in a large cohort of patients with congenital heart disease. Eur Child Adolesc Psychiatry 30, 647–655 (2021). https://doi.org/10.1007/s00787-020-01547-y

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  • DOI: https://doi.org/10.1007/s00787-020-01547-y

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