The Pediatric Clinician's Approach for Anxiety, Depression, and Suicide Ideation in Children with Sickle Cell Disease.

Management of Depression in Parkinson’s Disease

Association between comorbid depression and antidepressant adherence with adherence to disease-modifying therapies in patients with sickle cell disease in Texas Medicaid

Longitudinal relationship between parent–child attachment and suicidal ideation in children: Mediating roles of beliefs about adversity and hope

Classification of facial expressions of emotion and risk for suicidal ideation in children of depressed mothers: Evidence from cross-sectional and prospective analyses

25 years after Prozac

This study examined the reliability and validity of the Suicidal Ideation Questionnaire-Junior (SIQ-JR; Reynolds, 1987) as an instrument for identifying and assessing current suicidal ideation in a sample of 91 children and adolescents, aged 11 to 15 years who attended an inner-city parochial school. Participants completed the SIQ-JR as part of a screening procedure to identify youngsters who are at-risk for suicidal behavior. Psychometric results showed that the internal consistency reliability coefficient of the SIQ-JR was high, rα=.91, and the test-retest reliability coefficient was.89. Multiple regression results examining criterion-related validity showed that only the suicidal ideation factor of a clinical interview designed to assess suicidality was significantly related to SIQ-JR scores, β=.67, p <.001. The results of this study support the use of the SIQ-JR as a reliable and valid measure for the evaluation of suicidal ideation in children and young adolescents. The results and their implications for school psychologists are discussed.

Hydroxyurea is associated with reductions in hypercoagulability markers in sickle cell anemia

Background: Sickle cell disease (SCD) and sickle cell trait (SCT) have varying prevalence, which impacts global health. An especially high prevalence has been reported in sub-Saharan Africa, the Mediterranean, the Middle East, and India (Piel FB et al. 2017). The introduction of newborn screening programs has improved life expectancy of patients with SCD; still the mortality rate in some regions is high in children ≤3 years of age (Makani J et al. 2013). With an increased global population movement, the prevalence and disease burden of SCD are changing in various regions. However, there are currently no definitive data on global prevalence and mortality of SCD. Aims: A systematic literature review (SLR) on prevalence, birth prevalence, mortality, and life expectancy of SCD was performed to map the global epidemiological burden. The SLR also allowed identification of any gaps in current data. Methods: A search of bibliographic databases and proceedings from key conferences was performed to identify peer-reviewed studies reporting on SCD (including HbSS, HbSC, sickle beta thalassemia and regional SCD variants) and SCT epidemiology from January 1, 2010 to March 25, 2022 (congress abstracts 2018 to 2022 only). The SLR protocol followed PRISMA guidelines. Two independent reviewers screened titles and abstracts based on predefined inclusion and exclusion criteria. Study quality was assessed with the GRADE framework, adapted to observational studies. For quantitative analyses, studies with at-risk populations, groups not representative of general population, and population size <1,000 were excluded. A binomial normal (BN) random-effects model was applied to estimate prevalence and birth prevalence. Results: Of 1,770 journal articles and 468 abstracts screened, 115 publications met the inclusion criteria for the SLR. Birth prevalence studies were mostly based on cases identified through newborn screening programs. The qualitative and quantitative data showed gaps in the published literature, with missing data on prevalence and/or birth prevalence from key countries and regions. Moreover, no accurate conclusions could be made for mortality/life expectancy, as the number of publications was sparse and the few identified studies were heterogeneous in terms of reporting of SCD genotypes, diagnosis criteria, and study settings. This lack of data requires more research to determine up-to-date and adequate prevention and screening strategies, targeting causes of SCD mortality. Quantitative analyses on the global and regional prevalence and birth prevalence of SCD and SCT are shown in Table 1. If observing these parameters together in this SLR, to gain a comprehensive view, potential “hot spots” for SCD and SCT from high to low prevalence were Africa, Middle East, India, and South America/the Caribbean. Prevalence data for certain regions were inadequate to provide consistent results using the BN model in this SLR, demonstrating the need to scale up systematic data collection by registries, databases, and longitudinal studies. Conclusion: This SLR provides more insight into the global epidemiology of SCD, confirming earlier studies of areas with a high prevalence. However, this SLR demonstrates that resources are needed for additional studies across regions to provide uniform data collection on prevalence and mortality, ensuring an increased SCD awareness among healthcare professionals and public health policy makers worldwide.

Anxiety disorders are common in children and adolescents, with prevalence rates varying from 6 to 20%. These disorders can result in significant academic, social, and familial impairment. Early identification in pediatric primary care and effective management may help improve outcomes. Self-report measures of pediatric anxiety can supplement the clinical interview and assist in screening children and adolescents for separation anxiety disorder, generalized anxiety disorder, and social phobia. Substantial evidence supports the use of cognitive behavioral therapy and selective serotonin reuptake inhibitors in the treatment of pediatric anxiety disorders. Although treatment with serotonin reuptake inhibitors may lead to a small increase in the risk for suicidal ideation in children and adolescents, the risk benefit ratio for serotonin reuptake inhibitor use in pediatric anxiety disorders is favorable with appropriate monitoring. Although evidence-support treatments have emerged for pediatric anxiety disorders, their effectiveness in pediatric primary care has not been evaluated. Future research should assess the delivery of manual-based cognitive behavioral therapy for anxiety disorders by mental health professionals integrated into the primary care settings, the effectiveness of serotonin reuptake inhibitor prescription by pediatric primary care clinicians, and the use of collaborative models for providing anxiety treatments for children and adolescents in primary care settings.

SummaryBackgroundPrevious global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021.MethodsWe estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures—borrowing strength from predictive covariates and across age, time, and geography—and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs).FindingsBetween 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1–16·5), to 515 000 (425 000–614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3–44·9), from 5·46 million (4·62–6·45) in 2000 to 7·74 million (6·51–9·2) in 2021. We estimated 34 400 (25 000–45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000–467 000). In children younger than 5 years, there were 81 100 (58 800–108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021.InterpretationOur findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease.FundingBill & Melinda Gates Foundation.

Self-harm and suicidal ideation in children and adolescents are common and are risk factors for completed suicide. Social exclusion, which can take many forms, increases the risk of self-harm and suicidal ideation. One important marker of social exclusion in young people is school absenteeism. Whether school absenteeism is associated with these adverse outcomes, and if so to what extent, remains unclear. To determine the association between school absenteeism and both self-harm (including completed suicide) and suicidal ideation in children and adolescents, we conducted a systematic review of observational studies. We conducted meta-analysis and report a narrative synthesis where this was not possible. Meta-analysis of cross-sectional studies showed that school absenteeism was associated with an increased risk of self-harm [pooled adjusted odds ratio (aOR) 1.37, 95% confidence interval 1.20–1.57, P = 0.01] and of suicidal ideation (pooled aOR 1.20, 95% CI 1.02–1.42, P = 0.03). A small number of studies showed that school absenteeism had a longitudinal association with both adverse outcomes. Heterogeneity in the exposure and outcome variables, study design and reporting was prominent and limited the extent to which it was appropriate to pool results. School absenteeism was associated with both self-harm and suicidal ideation in young people, but this evidence was derived from a small number of cross-sectional studies. Further research into the mechanisms of this association could help to inform self-harm and suicide prevention strategies at clinical, school and population levels.

The association between renal function decline and disease severity in sickle cell disease.

Plasma FGF23 Is a Biomarker for Left Ventricular Hypertrophy and Mortality in Adults with Sickle Cell Anemia Chronic Kidney Disease

Management of Psychiatric Disorders with HIV and Dermatological Disorders.

Multi-Disciplinary Obstetrics and Sickle Cell Disease Clinic in Low Resource Setting Lowers Maternal and Perinatal Death Rates to the Same Levels As Those without Sickle Cell Disease