Mind the Heart, Online Screening of the Mental Health in Children and Adolescents With Congenital Heart Defects

The aim of the Mind the Heart study is to document the feasibility of an online parent/child administered screening model for mental disorders (MDs) in Danish children and adolescents with congenital heart disease (CHD). As MDs in children and adolescents with chronic somatic health issues are frequently underdiagnosed and undertreated, we further aim to develop a website with evidence based information on mental health in children and adolescents with CHD in order to promote knowledge and awareness among families and health professionals across sectors.

Background:

CHD affects approximately 6-10 children per 1000 live births. Innovations in somatic treatment during the last 50 years have increased survival in children with CHD, but also showed a higher risk of cognitive disabilities and MDs like depression, ADHD and autism in children and adolescents with CHD compared to the general population. Untreated childhood MDs may have serious implications for the child's social and academic functioning, quality of life, future health and employment.

Methods:

Danish children and adolescents diagnosed with CHD (N \~ 4800) will be identified through Danish national registries. Parents to eligible children and adolescents will complete bespoke online questionnaires on sociodemographic factors and received psychological support for their children. Parents and children ≥ 11 years will further complete the internet based Strengths and Difficulties Questionnaire (SDQ) and Development and Wellbeing Assessment (DAWBA). Based on their answers, the SDQ and DAWBA automatically calculates the likelihood that the child or adolescent meets diagnostic criteria for one or more psychiatric diagnoses. In order to increase validity of the diagnoses, the SDQ and DAWBA data will subsequently be rated by trained clinicians, and a summarising report of the results will be provided for the families within 3 months. Parents and children ≥ 11 years will be asked to complete a feasibility questionnaire on the screening procedure, including if they think it would be beneficial to adopt such a procedure in typical clinical practice.

A comparison control group of age- and sex-matched heart-healthy children, adolescents and their parents will be included aswell. The control group will be recruitet on a 10:1 basis.

In collaboration with families and cross-sectoral health care providers, a website will be developed. User needs will be identified through semi-structured interviews with representative end users, and the written content will be developed based on a systematic review of the scientific literature, including systematic reviews and meta-analysis, that either illuminates aetiological and maintaining factors for MDs in children and adolescents with CHD, or describes and tests various interventions, and a review of existing information material and management guidelines. The website will be hosted at Rigshospitalet. End user satisfaction will be evaluated through a bespoke questionnaire combined with the System Usability Scale.

The semi-structured interviews with the parent to children and adolescents with CHD and concurrent MDs will further be used for a qualitative study to explore their lived experiences of these issues (Linking Heart and Mind, described elsewhere (https://osf.io/93nb6)).

Eligibility Criteria:
Inclusion Criteria:

* Born with a Congenital Heart Defect
* Age 5-18y
* (Living in Denmark)

Exclusion Criteria:

* Younger than 5years of age
* Older than 18years of age
* Lacking sufficient Danish language skills to answer the questionnaire