An Integrated Adult Congenital Heart Disease Psychology Service
Bibliographic record
Abstract
OBJECTIVE: North American adults with congenital heart disease (CHD) are at increased risk of mood and anxiety disorders, although there are no published data on psychological treatment. In order to provide guidance to adult CHD (ACHD) programs considering the integration of psychological care, the aim of this study was to provide a comprehensive description of a specialized ACHD psychological service. DESIGN: At a large tertiary hospital, a retrospective review of 100 ACHD clinic patient psychology files was performed. The following data were abstracted: sociodemographic and medical background, presenting psychological concerns, and the course and outcome of psychological intervention. RESULTS: Of 100 patients, the mean age was 33 ± 11 years and 51% were female. Prevalent psychological concerns were generalized anxiety (82%), health-/heart-related anxiety (71%), depressed mood (60%), and difficulty coping with a medical condition (49%); 65% of patients met diagnostic criteria for a mood or anxiety disorder. Following assessment, individual psychotherapy was offered to 87 patients, of whom 75 opted to proceed with treatment. The median number of psychotherapy sessions was 8 and treatment most frequently included cognitive therapy (92%), relaxation skills training (57%), and communication skills training (46%). Of 64 patients for whom a course of psychotherapy had ended at the time of data abstraction, 54 (88%) had reduced or absent psychological distress. CONCLUSIONS: Reduced psychological distress can be achieved among adults with CHD who receive targeted psychological intervention. Consistent with the emerging field of behavioral cardiology, other ACHD programs as well as general cardiovascular programs are encouraged to integrate cardiac psychology services in order to provide comprehensive patient care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".