<p>Depression and Anxiety as Moderators of the Pain-Social Functioning Relationship in Youth with Sickle Cell Disease</p>

Abstract

Purpose: Youth with sickle cell disease (SCD), a genetic disorder of red blood cells, may experience acute pain episodes lasting 2 to 3 days on average. While existing research has demonstrated associations between SCD pain and poor social functioning in youth with SCD, there are no data on whether symptoms of depression and anxiety modify the relationship between pain and functional outcomes in pediatric pain populations. It was hypothesized that more symptoms of depression and anxiety would exacerbate the relationship between high pain and poor social functioning in youth with SCD. Patients and Methods: We conducted a cross-sectional study of 114 youth with SCD and their guardians assessing the youth's pain, social functioning, and symptoms of depression and anxiety. Results: Analyses indicated that elevated levels of depressive symptoms were related to poorer self-reported interpersonal skills. More anxiety symptoms were related to better guardian-reported social skills and weakened the relationship between high pain frequency and poor self-reported interpersonal skills. Conclusion: Findings build on previous work supporting the need for multidisciplinary approaches to care for youth with SCD who experience pain, and provide rationale for future studies to investigate the direct and possible moderating effects of depression and anxiety symptoms on other functional outcomes in youth with SCD and other pediatric pain populations.

Prevalence of clinical manifestations suggestive of depression in patients with sickle cell disease: a review

“…In the quality assessment, most records (44.4%/N = 03) scored 15, because they did not make clear the strategies for dealing with confounding factors [19][20][21][22] . Three studies had a maximum score 10,23,24 .…”

“…Among the nine studies, eight used cluster sampling and carried out the research in patients with sickle cell disease who were being followed up on an outpatient basis in a particular hematology center in the region studied 10,[19][20][21][22][23][24][25] .…”

“…It is important to note that most studies used data from medical records to confirm the diagnosis of sickle cell disease and its genotype (Sβ thalassemia, SC and SS) 20,21,[23][24][25] . Only two used hemoglobin electrophoresis 19,22 .…”

“…In all studies included in this review, the majority of the patients was black. In seven of these, there was a predominance of females [19][20][21][22][23][24]26 . However, none of the articles established statistical significance between the development of depression and the participant's gender.…”

Healthcare Utilization and the Quality of Life of Children and Adolescents with Sickle Cell Disease

“…The Pain in Sickle Cell Epidemiology Study (PiSCES) highlights this experience and reports that patients will typically manage their pain at home to avoid going to a busy ER (Smith et al, 2005). While the pain experience, which has been shown to increase with age, has been linked to mental health challenges such as depression and anxiety (Valrie et al, 2020), it is also the most common reason patients access the hospital (Kanter et al, 2019).…”