Association between elevated depressive symptoms and clinical disease severity in African-American adults with sickle cell disease.
OBJECTIVE
The purpose of this cross-sectional study was to examine the association between elevated depressive symptoms and the clinical severity of sickle cell disease (SCD) using African-American adults with and without SCD.


METHODS
The population consisted of 102 African-American adults with SCD, diagnosed using hemoglobin electrophoresis, individually matched on age (+/-5 years), gender and recruitment location to 103 African-American adults without SCD (mean age of all subjects was 35.4 years, 55.6% female). Logistic regression was used to examine the association between SCD clinical severity and elevated depressive symptoms in bivariate and multivariable analyses.


RESULTS
The prevalence of elevated depressive symptoms as measured using the 10-item Center for Epidemiological Studies Depression Scale (CES-D) was 38.6% in those with SCD, compared to 27.5% in those without SCD; however, this difference was not statistically significant (p>0.05). Compared to African Americans without SCD, African Americans with SCD were less educated, had lower incomes, and were more likely to be unemployed or disabled (p<0.01). The odds of having elevated depressive symptoms were 1.78 (CI: 0.94, 3.38) for those with high clinical SCD severity compared to those without SCD in bivariate analysis and 1.37 (CI: 0.62, 3.02) in multivariable analysis after adjusting for socioeconomic factors.


CONCLUSIONS
The reported relationship between elevated depressive symptoms and SCD may be a result of the adverse economic conditions associated with SCD.
Laurence
Brian
B
Howard University College of Dentistry, Washington, DC 20059, USA. blaurenc@yahoo.com
George
David
D
Woods
Dexter
D
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000755:Anemia, Sickle Cell / Q000208:ethnology* / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index