Systematic Review: Pain and Emotional Functioning in Pediatric Sickle Cell Disease

Area of Science:

• Pediatric Hematology
• Clinical Psychology
• Systematic Review

Background:

• Sickle Cell Disease (SCD) significantly impacts pediatric quality of life.
• Emotional functioning is a critical, yet understudied, aspect of SCD management in youth.
• Understanding the interplay between pain and emotional health is vital for comprehensive care.

Purpose of the Study:

• To systematically review and synthesize the literature on the relationship between pain and emotional functioning in pediatric SCD.
• To evaluate the current evidence base regarding pain frequency, intensity, duration, impairment, and coping in relation to emotional outcomes.
• To identify gaps in the literature and guide future research directions.

Main Methods:

• Systematic search of PsycINFO, PubMed, and CINAHL databases up to June 2018.
• Inclusion criteria focused on pediatric samples (up to age 21) with SCD, examining emotional functioning and pain-related variables.
• Final synthesis included 29 studies after screening and quality assessment.

Main Results:

• Strongest evidence links increased pain frequency to higher depressive and anxiety symptoms in pediatric SCD.
• Moderate-to-strong associations found between pain-related impairment and depressive symptoms.
• Small-to-strong associations observed between pain-related impairment and anxiety symptoms.
• Maladaptive cognitive pain-coping strategies demonstrated the strongest link with emotional functioning.

Conclusions:

• Pain frequency and impairment are significantly associated with adverse emotional functioning in pediatric SCD.
• Maladaptive coping mechanisms exacerbate emotional difficulties in this population.
• Future research requires adequately powered, prospective studies grounded in theoretical frameworks to deepen understanding.