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Introduction:Higher rates of depression, anxiety, and attention deficit hyperactivity disorder (ADHD) have been described in patients with congenital heart disease (CHD). These data are limited for younger cardiac arrhythmia (ARR) patients. Our goal of our study was to characterize depression/anxiety (DA) and ADHD in youth with ARR compared to the general population and other chronic diseases.Methods:Retrospective data was obtained from the electronic medical record of a large pediatric hospital between 2011-2016. We compared non-CHD ARR patients <18yo to CHD, cystic fibrosis (CF), sickle cell disease (SCD), and all other patients without these diagnoses (control). Predictor variables included age, sex, race/ethnicity, insurance type, and neighborhood poverty. Our primary outcome variable was an ICD-9 or 10 diagnosis and/or medication prescribed for DA or ADHD. Logistic regression analyses (using Stata v15) were used to predict DA, ADHD, or having both conditions for ARR and non-ARR patients.Results:We identified 251,020 unique patients and 7,371 ARR patients. ARR patients were largely <10 years old (68%), male (52%), Hispanic (45%), and had public insurance (57%). Overall, 21% of arrhythmia youth had a diagnosis or medication for DA compared to 24% of CHD youth, 23% of CF patients, 5% of SCD patients, and 3% of our control population. Compared to the control population, patients with ARR had ~9x higher odds of DA (OR 9.4; 95% CI 8.81, 9.94), and 4.7x higher odds of ADHD (OR 4.76; 95% CI 4.30, 5.25). Compared to CF and SCD patients, those with an ARR have 1.6x higher (OR 1.61; 95% CI 1.21, 2.13) and ~5x higher (OR 5.3; 95% CI 3.88, 7.28) odds of medication for/diagnosis of DA, respectively; patients with an ARR have 1.8x (OR 1.86; 95% CI 1.29, 2.69) the odds of ADHD compared with SCD patients. There was no significant interaction between a diagnosis of DA or ADHD and neighborhood poverty.Conclusions:Youth with ARR have a higher odds of DA medication or diagnosis compared to our control and patients with CF and SCD. Youth with ARR also have a higher odds of ADHD compared to control and SCD populations. DA and ADHD diagnoses were noted to be lower in SCD patients. Screening for DA and ADHD should be considered in youth with ARR as well as other chronic childhood diseases.

Background:The impact of childhood chronic conditions (congenital heart disease (CHD), sickle cell (SC), and cystic fibrosis (CF)) on mental health (MH) has been described in adults; however, these conditions? effects on MH and their potential interaction with poverty is unclear. Our goal was to describe the relationship between poverty, depression/anxiety (DA), and ADHD in youth with CHD, SC, CF and other children without these conditions (control).Methods:Data was obtained from electronic medical records (2011-2016) of a tertiary care pediatric hospital. Inclusion criteria were children <18 yo with >1 inpatient encounter and medication. Our primary predictor variable was having simple or complex CHD. Other predictor variables were age, sex, race, insurance, and neighborhood poverty. Medical records were linked via zip codes to characterize neighborhood poverty. Our primary outcome variable was having an ICD9/10 diagnosis and/or medication prescribed for DA or ADHD. Logistic regression analyses (Stata v15) were used to predict DA/ADHD for CHD, CF, SC and control patients.Results:We identified 251,020 patients; 6,612 with CHD, 322 with CF, and 839 with SC. The majority of CHD patients were <10 years old (90%), male (54%), and publicly insured (52%). Children with complex CHD had 17x higher odds (OR 17.37; 95% CI 15.81-19.09) of DA and 6x higher odds (OR 6.04; 95% CI 5.03-7.25) of ADHD compared to the control group. There was no difference in the odds of DA between complex CHD and CF; however, compared to children with SC, those with complex CHD had ~4x higher odds of DA (OR 3.81, 95% CI 2.68-5.23). For CHD vs the control, as neighborhood poverty increased, there was a slight increase in the odds of combined DA/ADHD (OR 1.03, 95% CI 1.00-1.05). There were no differences in ADHD or significant neighborhood poverty interaction between CHD, CF, or SC.Conclusions:Children with CHD and CF have higher odds of being diagnosed with or prescribed a medication for DA or ADHD compared to their peers with SC and without CHD. Poverty mildly increases the odds of a diagnosis of both DA and ADHD in youth with complex CHD. Future interventions should be directed towards increasing MH screening in these patients regardless of neighborhood poverty level.