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Depression and anxiety in adults with sickle cell disease: the PiSCES project.

James L Levenson1, Donna K McClish, Bassam A Dahman

  • 1Department of Psychiatry, Virginia Commonwealth University, Box 980268, Richmond, VA 23298, USA. jlevenson@mcvh-vcu.edu

Psychosomatic Medicine
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Depression and anxiety significantly worsen daily pain and reduce quality of life in adults with sickle cell disease (SCD). These mental health conditions impact pain severity, daily functioning, and opioid use more than hemoglobin type.

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Area of Science:

  • Hematology
  • Psychiatry
  • Pain Medicine

Background:

  • Sickle cell disease (SCD) is associated with significant psychological distress, including depression and anxiety.
  • The impact of these mental health conditions on the daily lives of adults with SCD remains underexplored.

Purpose of the Study:

  • To determine the prevalence of depression and anxiety in adults with SCD.
  • To investigate the effects of depression and anxiety on pain, quality of life, opioid use, and healthcare utilization in this population.

Main Methods:

  • Prospective cohort study of 308 adults with SCD (Pain in Sickle Cell Epidemiology Study).
  • Baseline assessments included demographics, genotype, quality of life, depression, and anxiety.
  • Daily diaries for up to 6 months tracked pain intensity, crisis status, distress, interference, and healthcare/opioid use.

Main Results:

  • Prevalence: 27.6% depressed, 6.5% with anxiety disorder among 232 completers.
  • Depression linked to more pain days (71.1% vs. 49.6%) and increased pain interference.
  • Both depression and anxiety correlated with poorer quality of life (SF-36 scores) and increased opioid use.

Conclusions:

  • Depression and anxiety are significant predictors of increased daily pain and diminished quality of life in adults with SCD.
  • Mental health status explained more variance in quality-of-life domains than hemoglobin type.
  • Findings highlight the need for integrated mental health care in SCD management.