Michelle Bardgett, doctoral student

Dissertation Title:  Understanding the Risk Factors and Care of Anxiety and Depression in Adolescents with Congenital Heart Disease
Exam Details: November 11, 2025
HSC Russell Hall  Room 217
10:00am-12:00pm ET

Survival for children born with congenital heart defects (CHD) has been improving over the past few decades. With this improvement, there is an increased need for understanding of the unique challenges these individuals face, even after repair or treatment of the heart defect. One of these challenges is the increased risk of anxiety and depression. Although recognized, modifiable risk factors for these symptoms, how these symptoms may impact anxiety about healthcare, and treatment for anxiety and depression are not well characterized in this population but are important for further optimizing long-term outcomes. Using data from children who were surgically treated for a congenital heart defect at Children’s Healthcare of Atlanta from 1998-2003, in this dissertation I evaluated the relationship between physical health and anxiety and depression using latent class analysis to construct physical health profiles among children with CHD. Children were categorized into two classes, one class characterized by reduced physical wellness and one by high physical wellness. We found that those children with reduced physical wellness had 3 times the prevalence of having anxiety and depression, adjusting for other factors including the severity of their heart defect. Using the same data, I assessed the prevalence of child- and parent-reported treatment anxiety and found that factors related to increased prevalence included physical health profile and having heart surgery after the age of 5, adjusting for other factors. Further, these associations seemed to be mediated through general anxiety which when added to the model was associated with a 1.8 times increase in prevalence of treatment anxiety and attenuated all other associations. Finally, using data from the National Survey of Children’s Health (NSCH), I identified factors related to receiving mental health treatment among children with a heart condition. Males, those without health insurance, not having a preventative check up in the last 12 months, and lower household income were associated with an increased prevalence of not receiving mental health care. There was an unadjusted association observed between having a heart condition and not receiving mental health treatment compared to those with other chronic health conditions, which may highlight specific barriers to care for those with a heart condition.