Overlapping Biological Mechanisms Underlying Sickle Cell Disease, Stress, and Depression

Abstract

After participating in this activity, learners should be better able to:1. Evaluate the overlap between sickle cell disease (SCD) and depression.2. Identify sources of psychological stress and biological vulnerabilities toward developing depression in patients with SCD.3. Assess the potential mechanisms underlying SCD, stress, and depression.Depression is a common co-occurring disorder in persons with sickle-cell disease (SCD). Individuals with this chronic illness may be particularly vulnerable to depression. In addition to risk factors for depression specifically related to SCD, these individuals typically experience further psychological stress due to multiple risk factors in their environment. To date, however, little research has focused on the co-occurring biological mechanisms across these conditions and how those mechanisms may interact to produce depressive symptoms. In this review we use a stress-vulnerability framework to describe the sources of psychological stress and the SCD factors that increase the risk of depression. We suggest that several biological factors, such as nitric oxide and cytokines, may play an important role in co-occurring stress, SCD, and depression. The interaction of these factors may be of particular importance for understanding the comorbidity of SCD and depression. Implications for current treatment and future research are discussed.

Oxygen - Mitochondrial fuel as a missing link in depressive pathophysiology

“…Increased MDD prevalence was observed in patients displaying dysfunctions in O2 transport, such as iron-deficiency anemia (38)(39)(40) and sickle-cell disease-related anemia (41,42). Diseases that prevent sufficient air inhalation such as chronic obstructive pulmonary disease (43,44), asthma (45), and COVID-19 ( 46) have also been associated with higher MDD risk, compared to general population.…”