Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T05:25:40.613Z Has data issue: false hasContentIssue false
  • English
  • Français

Quality of life and psychological co-morbidities in children and adolescents with cardiac pacemakers and implanted defibrillators: a cohort study in Eastern Germany

Published online by Cambridge University Press:  13 April 2020

Christian Paech ,
Victoria Ebel Open the ORCID record for Victoria Ebel [Opens in a new window] ,
Franziska Wagner ,
Stephanie Stadelmann ,
Annette M. Klein ,
Mirko Döhnert ,
Ingo Dähnert  and
Roman Antonin Gebauer
Christian Paech
Affiliation:
Department of Paediatric Cardiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289Leipzig, Germany
Victoria Ebel*
Affiliation:
Department of Paediatric Cardiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289Leipzig, Germany
Franziska Wagner
Affiliation:
Department of Paediatric Cardiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289Leipzig, Germany
Stephanie Stadelmann
Affiliation:
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Liebigstraße 20a, 04103Leipzig, Germany; LIFE – Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103Leipzig, Germany
Annette M. Klein
Affiliation:
International Psychoanalytic University, Stromstraße 1, 10555Berlin, Germany
Mirko Döhnert
Affiliation:
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Liebigstraße 20a, 04103Leipzig, Germany; LIFE – Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103Leipzig, Germany
Ingo Dähnert
Affiliation:
Department of Paediatric Cardiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289Leipzig, Germany
Roman Antonin Gebauer
Affiliation:
Department of Paediatric Cardiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289Leipzig, Germany
*
Author for correspondence: Victoria Ebel, Department of Paediatric Cardiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289Leipzig, Germany. Tel: +49-341-8651036; Fax: +49-341-8651143. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The implantation of a pacemaker or an implantable cardioverter-defibrillator during childhood may reduce quality of life and lead to mental health problems. This study aimed to evaluate potential mental health problems (i.e., depressive and anxiety symptoms) and quality of life in children with cardiac active devices in comparison to healthy peers.

Methods:

We analysed data of children with pacemakers or implantable cardioverter-defibrillators aged 6–18 years. Quality of life, depressive and anxiety symptoms were assessed by standardised questionnaires. The results were compared to age-matched reference groups.

Results:

Children with implantable cardioverter-defibrillator showed significant lower quality of life in comparison to reference group (p = 0.03), but there was no difference in quality of life between children with pacemaker and reference group. There was no significant difference in depressive symptoms between children with a cardiac rhythm device compared to reference group (self-report: p = 0.67; proxy report: p = 0.49). There was no significant difference in anxiety (p = 0.53) and depressive symptoms (p = 0.86) between children with pacemaker and children with implantable cardioverter-defibrillator.

Conclusions:

Living with an implantable cardioverter-defibrillator in childhood seems to decrease the patients’ quality of life. Although children with pacemaker and implantable cardioverter-defibrillator don’t seem to show more depressive and anxiety symptoms in comparison to their healthy peers, there still can be an increased risk for those children to develop mental health problems. Therefore, treating physicians should be aware of potential mental health problems and provide the patients and their families with appropriate therapeutic offers.

Keywords

Childrencardiac pacemakerdepressionquality of lifeimplantable cardioverter-defibrillator
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 4 , April 2020 , pp. 549 - 559
Copyright
© The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

These authors contributed equally to this project and should be considered co-first authors.

References

Bostwick, JM, Sola, CL.An updated review of implantable cardioverter/defibrillators, induced anxiety, and quality of life. Psychiatric Clin North Am 2007; 30(4): 677–688.CrossRefGoogle Scholar
Eicken, A, et al.Implantable cardioverter defibrillator (ICD) in children. Int J Cardiol 2006; 107(1): 30–35.CrossRefGoogle ScholarPubMed
SILVA, KR, et al.Quality of life and functional capacity after long-term right ventricular pacing in pediatrics and young adults with congenital atrioventricular block. Pacing Clin Electrophysiol 2013; 36(12): 1539–1549.CrossRefGoogle Scholar
Schron, EB, et al.Quality of life in the antiarrhythmics versus implantable defibrillators trial impact of therapy and influence of adverse symptoms and defibrillator shocks. Circulation 2002; 105(5): 589–594.CrossRefGoogle ScholarPubMed
Korte, T, et al.High incidence of appropriate and inappropriate ICD therapies in children and adolescents with implantable cardioverter defibrillator. Pacing Clin Electrophysiol 2004; 27(7): 924–932.CrossRefGoogle ScholarPubMed
Van Den Broek, KC, Habibović, M, Pedersen, SS.Emotional distress in partners of patients with an implantable cardioverter defibrillator: a systematic review and recommendations for future research. Pacing Clin Electrophysiol 2010; 33(12): 1442–1450.CrossRefGoogle ScholarPubMed
Thomas, SA, et al.Quality of life and psychological status of patients with implantable cardioverter defibrillators. Am J Crit Care 2006; 15(4): 389–398.CrossRefGoogle ScholarPubMed
DeMaso, DR, et al.Psychosocial factors and quality of life in children and adolescents with implantable cardioverter-defibrillators. Am J Cardiol 2004; 93(5): 582–587.CrossRefGoogle ScholarPubMed
Sola, CL, Bostwick, JM. Implantable cardioverter-defibrillators, induced anxiety, and quality of life. inMayo Clinic Proceedings. Elsevier 2005.CrossRefGoogle Scholar
Irvine, J, et al.Quality of life in the Canadian implantable defibrillator study (CIDS). Am Heart J 2002; 144(2): 282–289.CrossRefGoogle Scholar
Webster, G, et al.Psychiatric functioning and quality of life in young patients with cardiac rhythm devices. Pediatrics 2014; 133(4): e964–e972.CrossRefGoogle ScholarPubMed
Costa, R, et al.Incidence of shock and quality of life in young patients with implantable cardioverter-defibrillator. Arq Bras Cardiol 2007; 88(3): 258–264.CrossRefGoogle ScholarPubMed
Schuster, PM, et al.The psychosocial and physiological experiences of patients with an implantable cardioverter defibrillator. Rehab Nursing 1998; 23(1): 30–37.CrossRefGoogle ScholarPubMed
Pyngottu, A, et al.Health-related quality of life and psychological adjustment of children and adolescents with pacemakers and Implantable Cardioverter Defibrillators: a systematic review. Pediatr Cardiol 2019; 40(1): 1–16.CrossRefGoogle ScholarPubMed
Hamilton, GA, Carroll, DL.The effects of age on quality of life in implantable cardioverter defibrillator recipients. J Clin Nursing 2004; 13(2): 194–200.CrossRefGoogle ScholarPubMed
DeMaso, DR, Neto, LB, Hirshberg, J.Psychological and quality-of-life issues in the young patient with an implantable cardioverter-defibrillator. Heart Rhythm 2009; 6(1): 130–132.CrossRefGoogle Scholar
Sowell, LV, et al.Device implant technique and consideration of body image: specific procedures for implantable cardioverter defibrillators in female patients. J Womenʼs Health 2006; 15(7): 830–835.CrossRefGoogle ScholarPubMed
Walker, RL, et al.Women and the implantable cardioverter defibrillator: a lifespan perspective on key psychosocial issues. Clin Cardiol 2004; 27(10): 543–546.CrossRefGoogle ScholarPubMed
Leosdottir, M, et al.Health-related quality of life of patients with implantable cardioverter defibrillators compared with that of pacemaker recipients. Europace 2006; 8(3): 168–174.CrossRefGoogle ScholarPubMed
Freedenberg, VA, Thomas, SA, Friedmann, E.A pilot study of a mindfulness based stress reduction program in adolescents with implantable cardioverter defibrillators or pacemakers. Pediatr Cardiol 2015; 36(4): 786–795.CrossRefGoogle ScholarPubMed
Group, W.The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995; 41(10): 1403–1409.Google Scholar
Bettge, S, et al.Depressive symptoms of children and adolescents in a German representative sample: results of the BELLA study. Eur Child Adolesc Psychiatry 2008; 17(1): 71–81.CrossRefGoogle Scholar
Birmaher, B, et al., Childhood and adolescent depression: a review of the past 10 years Part I. J Am Acad Child Adolesc Psychiatry, 1996; 35(11): 1427–1439.CrossRefGoogle ScholarPubMed
Castillo, R, et al.Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association Press, Washington, DC, 2007.Google Scholar
Schulte-Markwort, M, Marutt, K, Riedesser, P.Crosswalk ICD-10–DSM IV. Huber-Verlag, Bern, 2002.Google Scholar
World Health Organization. International Classification of Diseases (ICD-10) World Health Organization. International Classification of Diseases and Causes of Death. 9th Revision. WHO, Geneva, 1975.Google Scholar
World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Wkly Epidemiol Rec = Relevé épidémiologique hebdomadaire 1992; 67(30): 227–227.Google Scholar
Quante, M, et al.The LIFE child study: a life course approach to disease and health. BMC Publ Health 2012; 12(1): 1021.CrossRefGoogle ScholarPubMed
Poulain, T, et al.The LIFE Child study: a population-based perinatal and pediatric cohort in Germany. Eur J Epidemiol 2017; 32(2): 145–158.CrossRefGoogle ScholarPubMed
Ravens-Sieberer, U, et al.The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods. Eur Child Adolesc Psychiatry 2008; 17(1): 10–21.CrossRefGoogle ScholarPubMed
Ravens-Sieberer, U, et al.The longitudinal BELLA study: design, methods and first results on the course of mental health problems. Eur Child Adolesc Psychiatry 2015; 24(6): 651–663.CrossRefGoogle ScholarPubMed
Hölling, H, et al.Der Kinder-und Jugendgesundheitssurvey (KiGGS): Studienmanagement und Durchführung der Feldarbeit. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2007; 50(5–6): 557–566.CrossRefGoogle Scholar
Kamtsiuris, P, Lange, M, Rosario, AS.Der Kinder-und Jugendgesundheitssurvey (KiGGS): stichprobendesign, response und nonresponse-analyse. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2007; 50(5–6): 547–556.CrossRefGoogle Scholar
Lange, M, et al.Messung soziodemographischer Merkmale im Kinder-und Jugendgesundheitssurvey (KiGGS) und ihre Bedeutung am Beispiel der Einschätzung des allgemeinen Gesundheitszustands. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2007; 50(5–6): 578–589.CrossRefGoogle Scholar
Erhart, M, et al.Measuring mental health and well-being of school-children in 15 European countries using the KIDSCREEN-10 Index. Int J Publ Health 2009; 54(2): 160–166.CrossRefGoogle ScholarPubMed
Ravens-Sieberer, U, et al.The European KIDSCREEN approach to measure quality of life and well-being in children: development, current application, and future advances. Qual Life Res 2014; 23(3): 791–803.CrossRefGoogle ScholarPubMed
Ravens-Sieberer, U, et al.Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Qual Life Res 2010; 19(10): 1487–1500.CrossRefGoogle Scholar
Weissman, MM, Orvaschel, H, Padian, NChildrenʼs symptom and social functioning self-report scales comparison of mothers’ and childrenʼs reports. J Nerv Mental Dis 1980; 168(12): 736–740.CrossRefGoogle ScholarPubMed
Weissman, MM, et al.Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 1977; 106(3): 203–14.CrossRefGoogle ScholarPubMed
Barkmann, C, et al.The German version of the Centre for Epidemiological Studies Depression Scale for Children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents–results of the BELLA study. Eur Child Adolesc Psychiatry 2008; 17(1): 116–124.CrossRefGoogle Scholar
Fendrich, M, Weissman, MM, Warner, V.Screening for depressive disorder in children and adolescents: validating the center for epidemiologic studees depression scale for children. Am J Epidemiol 1990; 131(3): 538–551.CrossRefGoogle ScholarPubMed
Birmaher, B, et al.The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 1997; 36(4): 545–553.CrossRefGoogle ScholarPubMed
Myers, K, Winters, NC.Ten-year review of rating scales. II: scales for internalizing disorders. J Am Acad Child Adolesc Psychiatry 2002; 41(6): 634–659.CrossRefGoogle ScholarPubMed
Crocetti, E, et al.Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the general Italian adolescent population: a validation and a comparison between Italy and The Netherlands. J Anxiety Disord 2009; 23(6): 824–829.CrossRefGoogle Scholar
Birmaher, B, et al.Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry 1999; 38(10): 1230–1236.CrossRefGoogle ScholarPubMed
Muris, P, Meesters, C, Fijen, P.The self-perception profile for children: further evidence for its factor structure, reliability, and validity. Pers Individ Differ 2003; 35(8): 1791–1802.CrossRefGoogle Scholar
Ruble, DN, et al.Developmental analysis of the role of social comparison in self-evaluation. Dev Psychol 1980; 16(2): 105.CrossRefGoogle Scholar
Harter, S.Causes and Consequences of Low Self-Esteem in Children and Adolescents, in Self-Esteem. Springer, 1993: 87–116.Google Scholar
Harter, S.Causes, correlates, and functional role of global self- worth: A life-span perspective. In: Sternberg RJ, Kolligian J (eds.). Competence considered, Yale University Press, New Haven, CT, 1990: 67–97.Google Scholar
Lampert, PDT, et al.Messung des sozioökonomischen Status in der KiGGS-Studie. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2014; 57(7): 762–770.CrossRefGoogle Scholar
Hansky, B, et al., Herzschrittmachertherapie im Kindesalter. Deutsches Arzteblatt-Arztliche Mitteilungen-Ausgabe A 1999; 96(42): 2660–2669.Google Scholar
Botsch, MP, et al.ICD therapy in children and young adults: low incidence of inappropriate shock delivery. Pacing Clin Electrophysiol 2010; 33(6): 734–741.CrossRefGoogle Scholar
Eckert, M, Jones, T.How does an implantable cardioverter defibrillator (ICD) affect the lives of patients and their families? Int J Nursing Prac 2002; 8(3): 152–157.CrossRefGoogle ScholarPubMed
Frizelle, D, et al.Development of a measure of the concerns held by people with implanted cardioverter defibrillators: the ICDC. Br J Health Psychol 2006; 11(2): 293–301.CrossRefGoogle ScholarPubMed
Godemann, F, et al.Determinants of the quality of life (QoL) in patients with an implantable cardioverter/defibrillator (ICD). Qual Life Res 2004; 13(2): 411–416.CrossRefGoogle Scholar
Heller, SS, et al.Psychosocial outcome after ICD implantation: a current perspective. Pacing Clin Electrophysiol 1998; 21(6): 1207–1215.CrossRefGoogle ScholarPubMed
Namerow, PB, et al.Quality-of-Life six months after CABG surgery in patients randomized to ICD versus No ICD therapy: findings from the CABG patch trial. Pacing Clin Electrophysiol 1999; 22(9): 1305–1313.CrossRefGoogle ScholarPubMed
Newall, E, et al.Psychological implications of ICD implantation in a New Zealand population. Europace 2007; 9(1): 20–24.CrossRefGoogle Scholar
Dougherty, CM.Psychological reactions and family adjustment in shock versus no shock groups after implantation of internal cardioverter defibrillator. Heart Lung: J Acute Crit Care 1995; 24(4): 281–291.CrossRefGoogle ScholarPubMed
Czosek, RJ, et al.Quality of life in pediatric patients affected by electrophysiologic disease. Heart Rhythm 2015; 12(5): 899–908.CrossRefGoogle ScholarPubMed
Czosek, RJ, et al.Impact of cardiac devices on the quality of life in pediatric patients. Circ: Arrhythmia Electrophysiol 2012; 5(6): 1064–1072.Google ScholarPubMed
Sears, SF, et al.Quality of life in pediatric patients with implantable cardioverter defibrillators. Am J Cardiol 2011; 107(7): 1023–1027.CrossRefGoogle ScholarPubMed
Rehm, LP.A self-control model of depression. Behav Ther 1977; 8(5): 787–804.CrossRefGoogle Scholar
Bourke, JP, et al.Florid psychopathology in patients receiving shocks from implanted cardioverter-defibrillators. Heart 1997; 78(6): 581–583.CrossRefGoogle ScholarPubMed
Pedersen, SS, et al.Concerns about the implantable cardioverter defibrillator: a determinant of anxiety and depressive symptoms independent of experienced shocks. Am Heart J 2005; 149(4): 664–669.CrossRefGoogle ScholarPubMed
Steinke, EE, et al.Sexual concerns and educational needs after an implantable cardioverter defibrillator. Heart Lung: J Acute Crit Care 2005; 34(5): 299–308.CrossRefGoogle ScholarPubMed
Sears, SF, et al.Predictors of quality of life in patients with implantable cardioverter defibrillators. Psychosomatics 2005; 46(5): 451–7.CrossRefGoogle ScholarPubMed
Sears, SF, et al.Managing congestive heart failure patient factors in the device era. Congestive Heart Failure 2006; 12(6): 335–340.CrossRefGoogle ScholarPubMed
Kuhl, EA, Sears, SF, Conti, JB.Using computers to improve the psychosocial care of implantable cardioverter defibrillator recipients. Pacing Clin Electrophysiol 2006; 29(12): 1426–1433.CrossRefGoogle ScholarPubMed
Stutts, LA, et al., Examination of research trends on patient factors in patients with implantable cardioverter defibrillators. Clin Cardiol 2007. 30(2): 64–68.CrossRefGoogle ScholarPubMed