Abstract
BackgroundSickle cell disease (SCD) is the commonest genetic disorder in Jamaica, and has life-long implications for those afflicted with it. It is well known that depression and loneliness may exist in those with chronic diseases, but the coexistence of depression and loneliness in people with sickle cell disease is not clear. The aim of this study is to determine the prevalence of and factors associated with depression and loneliness in the Jamaica Sickle Cell Cohort Study and its age and sex matched controls.Methods277 patients with SCD and 65 controls were administered a questionnaire that studied demographics, disease severity, depression, and loneliness. Regression analyses were done to examine relationships between outcomes and associated variables.ResultsDepression was found in 21.6% of patients and 9.4% in controls. Loneliness scores were also significantly higher in patients (16.9 ± 5.1) than in controls (14.95 ± 4.69). Depression was significantly associated with unemployment [OR = 2.9, p-value: < 0.001], whereas unemployment (p-value: 0.002), and lower educational attainment were significantly associated with loneliness.In patients with SCD, depression was significantly associated with being unemployed (OR 2.4, 95% CI 1.2,4.6, p-value:0.01), presence of a leg ulcer (OR = 3.8, 95% CI: 1.7, 8.4, p-value: 0.001), frequent visits (OR = 3.3, 95% CI: 1.2, 8.9, p-value: 0.019), and frequent painful crises (OR = 2.5, 95% CI: 1.1, 5.8, p-value: 0.035). Not being employed (Coef.: 2.0; p-value: 0.004) and higher educational attainment (tertiary vs. primary education, Coef.: -5.5; p-value: < 0.001) were significant associations with loneliness after adjusting for genotype.ConclusionsHealth workers need to actively look for and manage these problems to optimize their patients' total biopsychosocial care.
Highlights
Sickle cell disease (SCD) is the commonest genetic disorder in Jamaica, and has life-long implications for those afflicted with it
Further comparisons were done within the SCD cohort to determine differences between those who were not depressed (BDI scores: 4.6 ± 4.7) and those depressed (BDI scores: 25.8 ± 8.2) (Table 2)
This study confirms the fact that SCD is a chronic disease where the prevalence of depression and loneliness increases to higher levels than in the general population
Summary
Sickle cell disease (SCD) is the commonest genetic disorder in Jamaica, and has life-long implications for those afflicted with it. Lung diseases such as Acute Chest Syndrome, leg ulcerations, and priapism are common complications of the disease in Jamaica. These and other complications contribute a lot to the social isolation and lack of normal functioning in these patients. According to one survey [2], depression was found to be common in patients diagnosed with: recent heart attacks (45%), hospitalized cancer patients (42%), recent stroke survivors (40%), and people with multiple sclerosis (40%), Parkinson’s disease (40%), and diabetes (33%). Depression caused by chronic illness often aggravates the illness, especially if the condition causes pain, fatigue, or disruption of social life
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