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Exploring causal pathways of child behavior and maternal mental health in families with a child with congenital heart disease: a longitudinal study

Published online by Cambridge University Press:  29 November 2013

M. A. Landolt ,
E. Ystrom ,
K. Stene-Larsen ,
H. Holmstrøm  and
M. E. Vollrath
M. A. Landolt*
Affiliation:
Department of Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland
E. Ystrom
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
K. Stene-Larsen
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
H. Holmstrøm
Affiliation:
Department of Pediatrics, Oslo University Hospital, Norway
M. E. Vollrath
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway Department of Psychology, University of Oslo, Norway
*
*Address for correspondence: Professor M. A. Landolt, University Children's Hospital, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland. (Email: markus.landolt@kispi.uzh.ch)
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Abstract

Background.

A congenital heart defect (CHD) can increase the risk of mental health problems in affected children and their parents. The extent to which risk factors for these problems are shared in families or are specific to the individual family member is unclear.

Method.

Prospective data from the Norwegian Mother and Child Cohort Study (MoBa; n = 93 009) were linked with a nationwide CHD registry, and 408 children with CHD were identified. Mothers' reports on child internalizing problems and their own distress were assessed by questionnaires at child ages 6, 18 and 36 months. A structural model was applied to distinguish between familial (shared) factors and individual-specific factors for mental health problems.

Results.

CHD was a substantial risk factor for problems in children and their mothers at all time points. CHD contributed on average 31% and 39% to the variance in children's and mothers' problems respectively. Both shared familial and individual-specific factors unique to CHD families contributed to risk for mental health problems. Whereas individual-specific risk factors contributed to the stability of problems in mothers, the effect of these factors lasted only a short time in children. Mutual influences over time were found between the mother's and the child's mental health at 18 and 36 months.

Conclusions.

The burden of CHD in a child is shared between family members but is also specific to the individual. This study points to a need for both an individual and a family-based approach to provide psychological support to children with CHD and their parents.

Keywords

Childcongenital heart diseasemental healthmother
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 16 , December 2014 , pp. 3421 - 3433
Copyright
Copyright © Cambridge University Press 2013 

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