title: Depression, anxiety, and stress comorbidities in sickle cell anemia patients with vaso-occlusive crisis.
abstract: We investigated the association of sickle cell anemia (SCA) vaso-occlusive crisis (VOC) with depression, anxiety, and stress disorders among Bahraini patients and controls. This was a cross-sectional study that involved administering Depression Anxiety Stress Scales (DASS-21) consisting of structured depression, anxiety, and stress scales to SCA patients with (n=138) and without (n=105) VOC. Multinomial regression and correlation analysis were used in assessing the association of VOC with depression and/or anxiety and/or stress, after adjusting for other covariates. Significantly higher proportion of VOC patients was found among the severe-extremely severe anxiety (P<0.002) and stress (P=0.001) groups; the frequency of depressed patients was comparable between the 2 groups. Adjusting for age, sex, income, number of affected individuals per family, and HbS levels, mild-moderate (P=0.042; odds ratio=2.00; 95% confidence interval=1.03-3.91) and severe-extremely severe (P=0.004; odds ratio=4.43; 95% confidence interval=1.59-12.34) anxiety were independently associated with VOC. Both depression and stress were not associated with VOC after adjusting for these covariates. These results suggest a positive contribution of VOC to the increased rates of anxiety disorders among SCA patients, thereby recommending counseling SCA patients with repeated VOC for these psychologic comorbidities, in particular anxiety.
authors.affiliation: Department of Pediatrics, Salmaniya Medical Complex, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
authors.forename: Najat
authors.initials: N
authors.lastname: Mahdi
authors.forename: Khadija
authors.initials: K
authors.lastname: Al-Ola
authors.forename: Nahed Abdel
authors.initials: NA
authors.lastname: Khalek
authors.forename: Wassim Y
authors.initials: WY
authors.lastname: Almawi
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000453:epidemiology; D001008:Anxiety Disorders / Q000209:etiology*; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000473:pathology; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D013315:Stress, Psychological / Q000209:etiology