Psychiatric diagnosis in adolescents with sickle cell disease: a preliminary report

Sickle cell disease (SCD), the most common genetic hemoglobin disorder, affects more than 70,000 Americans, primarily those of African and Mediterranean descent. SCD, characterized by chronic hemolytic anemia; recurrent, episodic painful episodes; vaso-occlusive complications affecting multiple organ systems; and increased risk of infections, is associated with a shortened life span for affected individuals. However, recent medical advances have significantly increased survivability and quality of life for individuals with SCD. Despite these advances, adolescents with SCD continue to face many challenges of living with a chronic condition that requires lifelong medical management that may place them at risk of psychiatric symptoms and disorders. Studies focusing on children and adolescents with SCD suggest greater risks for psychosocial difficulties and depressive and anxiety symptoms. This article describes findings from a structured psychiatric interview administered to 40 adolescents and their parents. The rates of reported psychiatric diagnosis were significantly higher than those reported for the general population. Awareness of risks for psychiatric disorders in SCD could lead to increased identification and interventions that may improve medical and psychiatric outcomes.