Psychological Functioning in Pediatric Patients with Single Ventricle Congenital Heart Disease: A Meta-Analysis and Systematic Review Protocol

Abstract

Mental health is an important yet understudied area of care for patients with congenital heart disease. Through limited studies, it is known that children and adults with congenital heart disease have increased incidence of mental health disorders when compared to their peers [1-3]. Some studies estimate that over half of adult patients with congenital heart disease have significant symptoms of a mood or anxiety disorder [3], although it is very likely that these symptoms are underrecognized. It is also known that in adults with congenital heart disease, depression is responsible for the variability of self-reported health status of patients, including physical functioning [4]. A prior review and meta-analysis of patient with complex congenital heart disease showed an increased risk of internalizing and externalizing behavior problems, however this review was not specific to the single ventricle population [5]. A recent review and meta-analysis of patients with children and adults with single ventricle physiology found worse health-related quality of life outcomes in this population [6], however currently less is known about psychological functioning specifically in the pediatric single ventricle population. The aim of this systematic review is to summarize and meta-analyze the existing literature of psychological outcomes in pediatric single ventricle patients. It is hypothesized that pediatric patients with single ventricle heart disease will have an increased risk of internalizing and externalizing problems as compared to their peers.