Hybrid delivery of behavioral health screening and prevention intervention for pediatric heart transplant recipients and families: A randomized pilot study

Mental Health Care for Children with Heart Disease and Their Families: Practical Approaches and Considerations for the Pediatric and Pediatric Cardiology Clinician

Mental health conditions are a common comorbidity among children living with heart disease. Children with congenital heart disease are more likely to have a mental health condition than their unaffected peers or peers with other chronic illnesses, and mental health risk persists across their lifetime. While poorer mental health in adults with congenital heart disease is associated with worse overall health outcomes, the association between mental health and cardiac outcomes for children with heart disease remains unknown. Despite this, it is suspected that mental health conditions go undiagnosed in children with heart disease and that many affected children and adolescents do not receive optimal mental health care. In this article, we review mental health in congenital heart disease across the lifespan, across domains of care, and across diagnoses. Further directions to support mental health care for children and adolescents with heart disease include practical screening and access to timely referral and mental health resources.

Strengths-Based Programs for Youth at Risk for Toxic Stress: A Scoping Review of Programs Targeting Mental Health, Substance Use, Parenting Skills, and Family Functioning

This scoping review explores and describes recent strengths-based programs for use among youth (ages 12-24) at risk for toxic stress that target mental health (MH) or substance use (SU) outcomes through improving family functioning (FF) and/or parenting skills (PS). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, seven databases were searched for peer-reviewed articles published between 2018 and 2023. Inclusion criteria included articles describing programs delivered to both youth and caregivers that targeted MH or SU outcomes through improving FF and/or PS. Thirty-three articles describing 33 programs were identified, 25 of which were research studies. Programs predominantly employed behavioral frameworks with varied duration and caregiver involvement. Most targeted MH outcomes, with fewer addressing SU. Positive outcomes included reductions in youth depression and anxiety, and improvements in emotional regulation and FF. Gaps identified included a majority of studies conducted in high-income countries, a prevalence of non-experimental designs, and a lack of standardized outcome measures. Results highlight the potential of family-centered, relational health-based interventions in promoting youth resilience and identify a need for more rigorous evaluations, culturally-responsive interventions, and increased research in low- and middle-income countries. This review underscores the promise of these interventions while revealing significant areas for future research to enhance effectiveness and applicability among adversity-impacted youth.

Psychosocial conditions of children after liver transplant: Post-traumatic stress, depression, and anxiety

AIM

This study aimed to determine psychosocial conditions, post-traumatic stress, depression, and anxiety of children who underwent a liver transplant.

METHOD

This is a relational descriptive study, which was conducted between March 2019 and December 2020 in the Inonu University Liver Transplantation Institute Pediatric Liver Transplant Clinic. The "Child Information Form," "Child Post-Traumatic Stress Reaction Index," "State-Trait Anxiety Inventory for Children-Trait Form," and "Children's Depression Inventory" were used to collect data. The study was conducted with 71 children who had a previous liver transplant.

RESULTS

Of the participating children, 56.3% were girls, 63.4% continued their primary school education after the transplant, 32.5% were diagnosed with cirrhosis, 39.4% received the transplant in 2017, 32.4% received it from the mother, and 25.4% received it from a cadaveric donor. Although it had been at least 3 years since the transplant, 47.9% exhibited moderate and 43.7% severe post-traumatic stress responses. There was a significant negative relationship between the age of children with a liver transplant and trait anxiety and post-traumatic stress responses (path coefficients β = -0.268, p = 0.002; β = -0.166, p = 0.023, respectively). There was a significant positive relationship between anxiety and post-traumatic stress responses of the children after the transplant and there was a statistically significant relationship between the path coefficients (β = 0.750; p < 0.001).

CONCLUSION

Children who underwent a liver transplant had post-traumatic stress disorder, depression, and trait anxiety.