Skip to main content
    • Aa
    • Aa

Covert fears, anxiety and depression in congenital heart disease

  • S. Gupta (a1), R.M. Giuffre (a1), S. Crawford (a1) and J. Waters (a1)

This study compared anxiety, fears, depression and behavioural problems as occurring in children with congenital heart disease, comparing them with samples of normal children. It further considered the influence of maternal anxiety, as well as analyzing a subgroup of children with cyanotic forms of congenital heart disease to determine if they were at higher risk than acyanotic children for the problems identified.


We recruited 40 consecutive children with congenital heart disease without obvious psychoso-cial problems from the Cardiology clinic at the Alberta Children‘s Hospital. Of the 40 children, 39 families consented to have the children participate, of which 24 were cyanotic and 15 acyanotic. Children completed the revised versions of the Fear Survey Scale-Revised and the Child Manifest Anxiety Scale as well as the Child Depression Inventory. Mothers completed the Child Behaviour Checklist, and the State Trait Anxiety Scale.


Children with congenital heart diseases demonstrated more medical fears, and more physiological anxiety, than the normative samples. More specifically, children with cyanotic forms of congenital heart disease demonstrated more fears of the unknown, physiological anxiety, depression, and delinquent behaviors than the acyanotic children with congenital heart disease. Mothers of the children with cyanotic forms of congenital heart disease scored higher on both the state and trait scales, with higher maternal anxiety correlating with higher anxiety, medical fears and behavioral problems in the child.


In a clinical setting, children with congenital heart diseases who do not present with psychological adjustment problems are still at risk for covert physiological anxiety, medical fears, depression and behavioral problems. The children with cyanotic malformations represent a subgroup at higher risk for these problems, which may be further exacerbated by increased maternal anxiety.

Corresponding author
Dr. S. Gupta, Alberta Children‘s Hospital, 1820 Richmond Road SW, Calgary, Alberta T2T 5C7, Canada. Tel: (403)229-7970; Fax: (403)229-7086
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. T Nolan , B. Pless Emotional correlates and consequences of birth defects. J Pediatrics 1986; 109: 201–216.

3. A Eksi , J Molzan , I Savasir , N. Guler Psychological adjustment of children with mild and moderately severe asthma. Eur Child Adoles Psychiatry 1995; 4: 77–84.

6. R Myers-Vando , MS Steward , CH Folkins , P. Hines The effects of congenital heart disease on cognitive development, illness causality concepts and vulnerability. Am J Orthopsychiat 1979; 49: 617–625.

7. HH Kramer , D Awiszus , U Sterzel , A van Halteren , R. Claben Development of personality and intelligence in children with congenital heart disease. J Child Psychol Psychiat 1989; 30: 299–308.

8. P Bjornstad The impact of severe congenital heart disease on physical and psychosocial functioning in adolescents. Cardiol Young 1995; 5: 56–62.

10. PA Gustafsson , N-IM Kjellman , J Ludvigsson , M. Cederblad Asthma and family interaction. Arch Dis Child 1987; 62: 258–263.

11. JL Wallander , JW Varni , L Babani , HT Banis , KT. Wilcox Family resources as resistance factors for psychological malad-justment in chronically ill and handicapped children. J Pediatr Psychol 1989; 14: 157–173.

13. CA Warnes , JS. Sommerville Tricuspid atresia in adolescents and adults; current states and late complication. British Heart Journal 1986; 56: 535–543.

15. CG Last , G Francis , CC. Strauss Assessing fears in anxiety-disordered children with the Revised Fear Survey Schedule for Children (FSSC-R). J Clin Child Psychol 1989; 18: 137–141.

16. TH. Ollendick Reliability and validity of the Revised Fear Survey Schedule for Children (FSSC-R). Behav Res Therapy 1983; 21: 685–692.

19. N King , E Gullone , T. Ollendick Fears in children and adolescents with chronic medical conditions. J Clin Child Psychol 1990; 19: 173–177.

22. LJ Eason , AJ Finch Jr, W Brasted , CF. Saylor The assessment of depression and anxiety in hospitalized pediattic patients. Child Psychiatry and Human Development 1985; 16: 57–64.

26. A Butz , C. Alexander Anxiety in children with asthma. J Asthma 1993; 30: 199–209.

28. J Hambley , K Brazil , D Furrow , YY. Chaa Demographic and psychosocial characteristics of asthmatic children in a Canadian rehabilitation setting. J Asthma 1989; 26: 167–175.

31. LM. Linde Physical and emotional aspects of congenital heart disease in children. Am J Cardiol 1971; 27: 712713.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 4 *
Loading metrics...

Abstract views

Total abstract views: 123 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 29th June 2017. This data will be updated every 24 hours.