Longitudinal psychological assessment in tetralogy of Fallot.

To determine whether preoperative psychological testing in children with cyanotic heart disease could provide an accurate estimate of adult performance, we studied 21 subjects (mean age, 30.3 +/- 4.8 years) who had undergone surgical repair for tetralogy of Fallot between 1958 and 1966 (mean age, 8.7 +/- 3.9 years); 17 received childhood preoperative testing (mean age, 8.9 +/- 4.2) and four had early postoperative testing. Follow-up psychological tests administered in 1983 included Wechsler Adult Intelligence Scale Revised, Jackson Personality Research Form E, Rosenberg Self-Esteem Scale, and a questionnaire-interview on educational, occupational, and psychosocial status. Adult IQ (x = 93.4 +/- 15.6) and child IQ (x = 97.5 +/- 14.6) scores were highly correlated (r = 0.87, p less than 0.01), revealing considerable stability across 22.3 +/- 2.2 years. On 17 of 22 Jackson personality scales, the subjects (S) were within the normal range. Scoring below the 16th percentile were 11/21 S on intellectual curiosity, 9/21 S on adaptability to change, and 8/21 S on leadership skills. Scoring above the 84th percentile were 8/21 S on harm avoidance and 8/21 S on giving nurturance to others. Univariate one-way ANOVAs indicated that those subjects with the higher IQ scores had the higher incomes, job levels, and educational attainments. We conclude that the results of perioperative psychological testing in children with tetralogy of Fallot are congruent with postoperative adult intellectual and psychosocial status.