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Summary: Cognitive achievement, behavioural problems, and various dimensions of personality were assessed in 48 male and female patients with congenital heart disease (CHD) aged from 12 to 16 years in comparison to a control group. The CHD group showed a lower speed of cognitive processing but seemed to have less state-anxiety and to possess a higher superego strength. Male adolescents with CHD presented with a reduced perceived capacity and self-esteem. This was not true for adolescent girls with CHD. The negative self-concept of boys with CHD may be partly explained by reduced physical ability interfering with peer relationships. Clin Pediatr. 2002;41:17-24
Introduction
Improvements in cardiac surgery and perioperative care have reduced the mortality rate in children with congenital heart disease, and cardiologists are now taking care for an increasing number of adolescents and young adults with either corrected or palliated congenital heart defects. In this context many questions are to be answered, especially with regard to cognitive function and psychosocial aspects, which may have a great impact on quality of life.1
Cognitive function in children with congenital heart disease (CHD) has often been described as less favorable. The literature suggests that cyanosis may be an important causative factor.2 During the sensitive period of adolescence, the psychosocial demands of development are very complex even in healthy adolescents; they try to become independent individuals, separate from their families, and develop relationships outside the family. Concomitantly they are preoccupied with physical changes and appearance. If these demands are additionally influenced by CHD, situations become even more complicated. In particular, adolescents with heavy physical restrictions due to the severity of the disease seem to have various problems concerning psychosocial adaptation.3 The impossibility of taking part in all social and sports activities and feelings of "being different," in addition to the normal sensitivity of this period, may lead to experiences of failure and ostracism. These negative experiences exhibit self-destructive tendencies, sadness, depression, and loneliness.4 Often confirmed in various situations, these experiences may also lead to the development of a negative self-concept.5 Furthermore, living with CHD may be more difficult for men than for women.fe The purposes of this study were the following: (1) to compare cognitive function, various dimensions of personality, and behavioral problems of adolescents with CHD to...