Behavioral impact of sickle cell disease in young children with repeated hospitalization

Abstract

Background:Sickle cell disease (SCD) in children with a history of repeated hospitalization is distressing for children as well as their parents leading to anxiety and has negative effects on the psychological state of children and their families. Objective: The aim of the study was to determine the overall effect of SCD on the behavior of young children age 1½ to 5 years old who had repeated history of hospitalization, compared to a control group of healthy children attended a vaccination clinic.Patients and Methods:Thirty-five children of age 1½ to 5 years who have SCD and repeated history of hospitalization were recruited from pediatric clinic as the study group and matched with same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist (CBCL) 1½ to 5 years and diagnostic and statistical (DSM)-oriented scale. Behavior data were collected through a semi-structured questionnaire.Results:Children who have SCD had statistically significant behavioral changes on CBCL compared to the control group: Anxiety/depression (65.2 vs. 55.1; P < 0.001), somatic complaint (66.7 vs. 54.4; P < 0.001) withdrawn (63.4 vs. 53.2; P < 0.001), aggressive behavior (60.4 vs. 56; P=0.04), and internalizing symptoms (64.7 vs. 51.5; P < 0.001), respectively. The DSM scale showed that children with SCD scored significantly higher in pervasive developmental disorder compared to the control group (60.9 vs. 53.9; P < 0.001) respectively.Conclusion:Children with SCD who had history of repeated hospitalization are at an increased risk of developing behavioral problems. Psychological counseling, social support, and proper pain management could minimize these behavioral consequences.

The Effectiveness of Self Management Program on Pain, Fatigue, Depression, Anxiety, and Stress in Sickle Cell Patients: A Quasi-Experimental Study

“…Other research has found a relationship between pain and psychiatric disorder, and has demonstrated that reduced pain is associated with significant improvements in general health, quality of life, and mood disorder in SC patients (3,15). Bakri et al (10) found that patients with SCD and who had history of repeated hospitalization are at an increased risk of developing behavioral problems and psychiatric disorders, including depression and anxiety. That study reported that psychological counseling, social support, and proper pain management may minimize these consequences.…”

“…Bakri et al (10) showed that depression, anxiety and stress are prevalent in SC patients compared with healthy subjects. Sogutlu et al (18) also showed that 60% and 37.5% of patients with SCD experience significant anxiety and depression, respectively.…”

“…In managing serious and unpredictable complications, patients with SCD suffer numerous psychosocial problems such as reduced self-esteem, feelings of frustration (7), depression (7)(8)(9), anxiety and stress (8), and disruption of interpersonal relationships (10); these often lead to fatigue (11)(12)(13)(14) and poor quality of life (13,(15)(16)(17) in these patients. Bakri et al (10) showed that depression, anxiety and stress are prevalent in SC patients compared with healthy subjects.…”

Palliative Care Teams as Advocates for Adults with Sickle Cell Disease

“…Delayed emotional, sociobehavioral, and cognitive progress contribute significantly to impaired psychosocial functioning, altered intraand interpersonal relationships, and reduced quality of life. 44 This arrested psychosocial development can continue into adulthood and it has been shown that behavioral and adaptive function becomes poorer with older age. 45 Specifically, those with chronic diseases such as SCD have been shown to have higher rates of both depression and anxiety, 44 which have the potential to be overlooked in those with SCD due to frequent hospitalizations and crises.…”

“…44 This arrested psychosocial development can continue into adulthood and it has been shown that behavioral and adaptive function becomes poorer with older age. 45 Specifically, those with chronic diseases such as SCD have been shown to have higher rates of both depression and anxiety, 44 which have the potential to be overlooked in those with SCD due to frequent hospitalizations and crises. Anxiety and depression can worsen the perception of pain, and uncontrolled pain can exacerbate these comorbidities.…”