title: Behavioral impact of sickle cell disease in young children with repeated hospitalization.
abstract: BACKGROUND
  Sickle cell disease (SCD) in children with a history of repeated hospitalization is distressing for children as well as their parents leading to anxiety and has negative effects on the psychological state of children and their families.
  
  
  OBJECTIVE
  The aim of the study was to determine the overall effect of SCD on the behavior of young children age 1½ to 5 years old who had repeated history of hospitalization, compared to a control group of healthy children attended a vaccination clinic.
  
  
  METHODS
  Thirty-five children of age 1½ to 5 years who have SCD and repeated history of hospitalization were recruited from pediatric clinic as the study group and matched with same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist (CBCL) 1½ to 5 years and diagnostic and statistical (DSM)-oriented scale. Behavior data were collected through a semi-structured questionnaire.
  
  
  RESULTS
  CHILDREN WHO HAVE SCD HAD STATISTICALLY SIGNIFICANT BEHAVIORAL CHANGES ON CBCL COMPARED TO THE CONTROL GROUP: Anxiety/depression (65.2 vs. 55.1; P < 0.001), somatic complaint (66.7 vs. 54.4; P < 0.001) withdrawn (63.4 vs. 53.2; P < 0.001), aggressive behavior (60.4 vs. 56; P=0.04), and internalizing symptoms (64.7 vs. 51.5; P < 0.001), respectively. The DSM scale showed that children with SCD scored significantly higher in pervasive developmental disorder compared to the control group (60.9 vs. 53.9; P < 0.001) respectively.
  
  
  CONCLUSIONS
  Children with SCD who had history of repeated hospitalization are at an increased risk of developing behavioral problems. Psychological counseling, social support, and proper pain management could minimize these behavioral consequences.
authors.affiliation: Department of Anesthesia, Children's Hospital, Faculty of Medicine, Assiut University, Egypt.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Bakri
authors.affiliation: Department of Anesthesia, Children's Hospital, Faculty of Medicine, Assiut University, Egypt.
authors.forename: Eman A
authors.initials: EA
authors.lastname: Ismail
authors.affiliation: Department of Pediatric, Children's Hospital, Faculty of Medicine, Assiut University, Egypt.
authors.forename: Ghada O
authors.initials: GO
authors.lastname: Elsedfy
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Mansoura University, Egypt.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Amr
authors.affiliation: Department of Community Medicine, Faculty of Medicine, University of Western Kordofan, Sudan.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ibrahim
keywords: Behavioral; CBCL 1½-5; SCD; hospitalization; pediatric