TABLE 3.
Associations between mental health conditions and characteristics among adults with CHDs, MarketScan® Commercial Database, 2017
| Characteristics | Any anxiety or depressive disorder | Post-traumatic stress disordera | Anxiety disorder | Depressive disorder | ||||
|---|---|---|---|---|---|---|---|---|
| n (%) | aPRb (95% CI) | n (%) | aPRb (95% CI) | n (%) | aPRb (95% CI) | n (%) | aPRb (95% CI) | |
| Congenital heart defect severityc | ||||||||
| Severe CHDs | 513 (12.9) | 1.1 (1.0, 1.2) | 34 (0.9) | 1.1 (0.7, 1.7) | 398 (10.0) | 1.0 (0.9, 1.1) | 269 (6.8) | 1.1 (1.0, 1.3) |
| Nonsevere CHDs | 1,200 (12.2) | Ref | 76 (0.8) | Ref | 973 (9.9) | Ref | 602 (6.1) | Ref |
| Aged | ||||||||
| 18–29 | 756 (12.4) | 1.0 (0.9, 1.1) | 44 (0.7) | 0.9 (0.6, 1.5) | 619 (10.1) | 1.1 (0.9, 1.2) | 384 (6.3) | 1.0 (0.9, 1.2) |
| 30–39 | 454 (12.2) | 0.9 (0.8, 1.0) | 35 (0.9) | 1.1 (0.7, 1.7) | 368 (9.9) | 1.0 (0.8, 1.1) | 233 (6.2) | 0.9 (0.8, 1.1) |
| 40–49 | 503 (12.7) | Ref | 31 (0.8) | Ref | 384 (9.7) | Ref | 254 (6.4) | Ref |
| Sex | ||||||||
| Female | 1,067 (15.1) | 1.6 (1.5, 1.8) | 85 (1.2) | 3.3 (2.1, 5.1) | 868 (12.3) | 1.7 (1.5, 1.9) | 555 (7.9) | 1.7 (1.5, 2.0) |
| Male | 646 (9.6) | Ref | 25 (0.4) | Ref | 503 (7.4) | Ref | 316 (4.7) | Ref |
| Region of residence | ||||||||
| Northeast | 476 (14.0) | 1.2 (1.0, 1.4) | 27 (0.8) | 0.8 (0.5, 1.4) | 376 (11.0) | 1.2 (1.0, 1.4) | 228 (6.7) | 1.0 (0.8, 1.2) |
| North Central | 391 (12.3) | 1.1 (0.9, 1.3) | 32 (1.0) | 1.0 (0.6, 1.8) | 316 (9.9) | 1.1 (0.9, 1.3) | 211 (6.6) | 1.0 (0.8, 1.3) |
| South | 591 (11.7) | 1.0 (0.9, 1.2) | 28 (0.6) | 0.5 (0.3, 0.9) | 471 (9.3) | 1.0 (0.8, 1.2) | 285 (5.7) | 0.8 (0.7, 1.0) |
| West | 252 (11.8) | Ref | 23 (1.1) | Ref | 206 (9.6) | Ref | 145 (6.8) | Ref |
| Outpatient encounters without mental health psychosocial treatmente | ||||||||
| 1–5 encounters | 280 (5.4) | Ref | 12 (0.2) | Ref | 209 (4.0) | Ref | 136 (2.6) | Ref |
| 6–10 encounters | 360 (10.9) | 2.0 (1.7, 2.3) | 17 (0.5) | 2.1 (1.0, 4.4) | 287 (8.7) | 2.2 (1.8, 2.6) | 155 (4.7) | 1.8 (1.4, 2.3) |
| 11–15 encounters | 288 (15.5) | 2.9 (2.4, 3.3) | 16 (0.9) | 3.3 (1.6, 7.1) | 228 (12.2) | 3.0 (2.5, 3.6) | 151 (8.1) | 3.1 (2.5, 3.9) |
| 16–20 encounters | 204 (18.7) | 3.4 (2.9, 4.1) | 11 (1.0) | 3.8 (1.7, 8.7) | 167 (15.3) | 3.8 (3.1, 4.6) | 109 (10.0) | 3.8 (2.9, 4.8) |
| More than 20 encounters | 571 (24.9) | 4.6 (4.0, 5.3) | 53 (2.3) | 8.8 (4.7, 16.6) | 472 (20.6) | 5.2 (4.4, 6.0) | 316 (13.8) | 5.3 (4.3, 6.4) |
| Inpatient admissionf | ||||||||
| Yes | 381 (21.9) | 1.1 (1.0, 1.3) | 41 (2.4) | 1.9 (1.2, 2.9) | 310 (17.8) | 1.1 (1.0, 1.3) | 223 (12.8) | 1.3 (1.1, 1.5) |
| No | 1,332 (11.0) | Ref | 69 (0.6) | Ref | 1,061 (8.8) | Ref | 648 (5.4) | Ref |
| Surgical cardiovascular encounterf,g | ||||||||
| 0 encounters | 1,649 (12.2) | Ref | 107 (0.8) | Ref | 1,318 (9.7) | Ref | 838 (6.2) | Ref |
| ≥1 encounter | 64 (23.8) | 1.2 (1.0, 1.5) | 3 (1.1) | 0.8 (0.2, 2.5) | 53 (19.7) | 1.3 (1.0, 1.6) | 33 (12.3) | 1.2 (0.9, 1.7) |
| Catheterization cardiovascular encounterf,g | ||||||||
| 0 encounters | 1,625 (12.2) | Ref | 105 (0.8) | Ref | 1,299 (9.8) | Ref | 824 (6.2) | Ref |
| 1 encounter | 62 (15.9) | 0.9 (0.7, 1.2) | 3 (0.8) | 0.6 (0.2, 1.9) | 50 (12.8) | 0.9 (0.7, 1.2) | 33 (8.5) | 0.9 (0.6, 1.3) |
| ≥2 encounters | 26 (23.2) | 1.1 (0.8, 1.5) | 2 (1.8) | 1.1 (0.3, 4.4) | 22 (19.6) | 1.1 (0.8, 1.7) | 14 (12.5) | 1.1 (0.7, 1.8) |
| Noninvasive cardiovascular encounterf,g | ||||||||
| 0 encounters | 622 (10.7) | Ref | 42 (0.7) | Ref | 496 (8.6) | Ref | 318 (5.5) | Ref |
| 1 encounter | 458 (10.9) | 0.9 (0.8, 1.0) | 24 (0.6) | 0.7 (0.4, 1.2) | 348 (8.3) | 0.9 (0.8, 1.0) | 232 (5.5) | 0.9 (0.8, 1.1) |
| ≥2 encounters | 633 (16.6) | 1.0 (0.9, 1.1) | 44 (1.2) | 0.9 (0.6, 1.4) | 527 (13.9) | 1.0 (0.9, 1.2) | 321 (8.4) | 0.9 (0.8, 1.1) |
Note: Boldface indicates statistical significance at α < .05.
Abbreviations: aPR, adjusted prevalence ratio; CHD, congenital heart defects; CI, confidence interval.
Post-traumatic stress disorder is a subset of anxiety disorders.
Adjusted prevalence ratios: Type of congenital heart defect and outpatient encounters without mental health counseling adjusted for categorical age (18–29 years, 30–39 years, 40–49 years), sex, and region; Age adjusted for sex and region; Sex adjusted for categorical age and region, Region adjusted for categorical age and sex; Inpatient admissions and Encounter with cardiovascular procedures adjusted for categorical age, sex, region, and total outpatient encounters without psychosocial treatment.
Individuals were considered to have severe CHDs if they had ICD codes for common truncus, transposition of the great arteries, complete transposition of the great arteries not otherwise specific, double outlet right ventricle or incomplete transposition of the great arteries, corrected transposition of the great arteries, other transposition of the great arteries, tetralogy of Fallot, single ventricle or cor triloculare, endocardial cushion defect, endocardial cushion defect unspecified, atrial septal defect primum, endocardial cushion defect other specified, pulmonary valve atresia or absence, tricuspid atresia stenosis or absence, hypoplastic left heart syndrome, interrupted aortic arch, total anomalous pulmonary venous return.
Age as of January 1, 2017.
Among individuals with at least one outpatient encounter without psychosocial treatment.
In 2017.
Any inpatient or outpatient encounter that included a cardiovascular procedure code.