Depression and Anxiety in Adults With Sickle Cell Disease: The PiSCES Project

Levenson, James L.; McClish, Donna K.; Dahman, Bassam; Bovbjerg, Viktor E.; Cítero, Vanessa de Albuquerque; Penberthy, Lynne; Aisiku, Imoigele P.; Roberts, John D.; Roseff, Susan D.; Smith, Wally R.

doi:10.1097/psy.0b013e31815ff5c5

Cited by 193 publications

(252 citation statements)

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“…48 In SCD, the PISCES investigators found an association between the diagnosis of depression in SCD and lower quality-of-life outcomes on all 8 subscales of the SF-36. 37 The SCD Consortium report found HRQoL outcomes to be significantly worse on all subscales in adult SCD patients than in the general population. 49 Further, a strong association was found between the use of antidepressants, reflecting a diagnosis of depression and worse HRQoL outcomes on all scales except mental health.…”

Section: Discussionmentioning

confidence: 95%

“…9 In addition, adults with SCD who report more frequent painful episodes are more likely to report depressive symptoms. 37 Available evidence shows that affective disturbance and psychosocial factors are involved in negative medical outcomes, including increased frequency, duration, and intensity of painful episodes and adverse psychosocial consequences in patients with SCD. 7,11,[38][39][40] Further, negative or maladaptive cognitions, a particular feature of depression, are associated with poorer medical outcomes, passive adherence to medical directives, increased levels of psychological distress, and decreased capacity to cope with pain.…”

Section: Discussionmentioning

confidence: 99%

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Depression, quality of life, and medical resource utilization in sickle cell disease

et al. 2017

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Key Points• Depression was found in 35.2% of adult SCD patients and was strongly associated with worse physical and mental quality-of-life outcomes.• Total health care costs for adult SCD patients with depression were more than double those of SCD patients without depression.Sickle cell disease (SCD) is a chronic, debilitating disorder. Chronically ill patients are at risk for depression, which can affect health-related quality of life (HRQoL), health care utilization, and cost. We performed an analytic epidemiologic prospective study to determine the prevalence of depression in adult patients with SCD and its association with HRQoL and medical resource utilization. Depression was measured by the Beck Depression Inventory and clinical history in adult SCD outpatients at a comprehensive SCD center. HRQoL was assessed using the SF36 form, and data were collected on medical resource utilization and corresponding cost. Neurocognitive functions were assessed using the CNS Vital Signs tool.Pain diaries were used to record daily pain. Out of 142 enrolled patients, 42 (35.2%) had depression. Depression was associated with worse physical and mental HRQoL scores (P , .0001 and P , .0001, respectively). Mean total inpatient costs ($25 000 vs $7487, P 5 .02) and total health care costs ($30 665 vs $13 016, P 5 .01) were significantly higher in patients with depression during the 12 months preceding diagnosis. Similarly, during the 6 months following diagnosis, mean total health care costs were significantly higher in depressed patients than in nondepressed patients ($13 766 vs $8670, P 5 .04). Depression is prevalent in adult patients with SCD and is associated with worse HRQoL and higher total health care costs. Efforts should focus on prevention, early diagnosis, and therapy for depression in SCD.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Depression, quality of life, and medical resource utilization in sickle cell disease

et al. 2017

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“…The higher the patient's anxiety was, the more days he or she experienced pain, with or without pain crises. 9 Patients with sickle cell disease showed lower quality of life in mental component scores, compared with patients with cystic fibrosis, as well as lower scores in the "bodily pain, " "vitality" and "social functioning" domains, in comparison with asthma patients. 3 Compared with patients undergoing dialysis, sickle cell patients also showed less "bodily pain, " "general health" and "vitality".…”

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confidence: 92%

The relationship between genotype, psychiatric symptoms and quality of life in adult patients with sickle cell disease in São Paulo, Brazil: a cross-sectional study

et al. 2015

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A relação entre genótipo, sintomas psiquiátricos e qualidade de vida em pacientes adultos com doença falciforme em São Paulo, Brasil: um estudo transversal ) showed lower scores for the "general health" and "role-physical" HRQoL domains, without interference from psychiatric symptoms. In the "role-physical" domain, the more severe genotype operated as a protective factor for HRQoL (β = 0.255; P = 0.007). CONCLUSION: The more severe genotypes worsened HRQoL in two domains of physical health (general health and role-physical), but they did not have any influence on mental health, thus suggesting that physicians should be more attentive to aspects of HRQoL relating to the functionality of sickle cell disease patients, so as to be aware of the limitations that these patient live with. RESUMOCONTEXTO E OBJETIVO: A qualidade de vida relacionada à saúde (QVRS) pode ser piorada em pacientes com doença falciforme na presença de transtornos psiquiátricos. O objetivo deste estudo é descrever a sintomatologia psiquiátrica presente no paciente brasileiro com doença falciforme e avaliar a relação desses sintomas com o genótipo da doença e a QVRS do sujeito. ) apresentaram menores médias nos domínios de QVRS de "saúde geral" e de "aspectos físicos", sem interferência dos sintomas psiquiátricos. No domínio "aspectos físicos", o genó-tipo mais grave funcionou como fator protetor da QVRS (β = 0,255; P = 0,007). CONCLUSÃO: Os genótipos mais graves pioraram a QVRS em dois domínios do componente físico ("aspectos físicos" e "saúde geral"), mas não influenciaram o componente mental, sugerindo que o médico deve estar atento aos aspectos da QVRS relacionados com a funcionalidade do portador da doença falciforme, conhecendo as limitações com as quais o paciente convive. IMSc. Psychologist,

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“…All pain is felt to be worsened by major psycho-social issues but this is consistently and well documented in individuals with SCD [13][14][15]. Like other chronic diseases that manifest in childhood (rheumatoid arthritis, cystic fibrosis), many sickle cell disease patients require frequent prolonged hospitalizations during childhood and adolescence that are barriers to education and the attainment of developmental milestones.…”

Section: Acute On Chronic Painmentioning

confidence: 99%

“…While many studies have associated mood disorders ranging from mania to major depressive disorder as predictors of higher utilization of resources, the literature is very inconclusive due to the research methods used and the populations studied [13,14,39]. Depression has been stated to be a predictor of higher utilization but when defined as a major depressive disorder as characterized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the association is not statistically significant [14,40].…”

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confidence: 99%

Navigating the Pain, Psychosocial and Racial Dynamics of Hospitalized Patients with Sickle Cell Disease

Mitchell¹

2018

Arch Med

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Hospital readmissions are receiving more attention because of the implications on cost and quality of care. Many researchers and clinicians believe that a substantial number of readmissions are preventable as evidenced by the significant reductions achieved after the Hospital Readmission Reduction Program mandated by the Affordable Care Act. While sickle cell disease is not currently one of the diseases designated for inclusion in the Hospital Readmission Reduction Program, some of the lessons learned addressing hospital structural characteristics and processes of care can be applied to this population.Acute worsening of chronic pain is the predominant clinical presentation of patients with sickle cell disease to the hospital. Pain and the measurement of pain is subjective and there are no clearly defined objective clinical criteria or biomarkers to validate or refute the presence of acute sickle cell pain crisis. The current epidemic of nonmedical opioid use and medical opioid abuse combined with racial unrest and governmental oversight in the US worsens a wellknown atmosphere of mistrust on the part of both clinicians and patients with sickle cell disease. These dynamics force the need for a paradigm change in management of these patients.

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Depression and Anxiety in Adults With Sickle Cell Disease: The PiSCES Project

Abstract: Depression and anxiety predicted more daily pain and poorer physical and mental quality-of-life in adults with SCD, and accounted for more of the variance in all domains of quality-of-life than hemoglobin type.

Cited by 193 publications

References 28 publications

Depression, quality of life, and medical resource utilization in sickle cell disease

Depression, quality of life, and medical resource utilization in sickle cell disease

The relationship between genotype, psychiatric symptoms and quality of life in adult patients with sickle cell disease in São Paulo, Brazil: a cross-sectional study

Navigating the Pain, Psychosocial and Racial Dynamics of Hospitalized Patients with Sickle Cell Disease

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