Psychosocial Complications in Sickle Cell Anaemia

Introduction: Adolescents with sickle cell anaemia (SCA) are challenged by a myriad of complex psychosocial issues which may arise as complications of living with the disorder. The magnitude of these psychosocial adjustment issues is scarcely being assessed, as more focus is often given to the physical symptoms and signs of SCA.

Objectives: This study sought to assess the prevalence of psychosocial complications (depression, avoidance of the health care system, social withdrawal and suicidal ideation) in adolescents with SCA in steady state, seen at the University of Port Harcourt Teaching Hospital (UPTH) and to compare this with the prevalence of same psychosocial complications in non-SCA controls matched for age, gender and socioeconomic class.

Methodology: Using a cross-sectional design, 200 adolescents with SCA (subjects) were recruited consecutively from the Paediatric Haematology Clinic of UPTH. Controls matched for age, gender, and socio-economic class, with haemoglobin genotype AA or AS were recruited from the Children Outpatient Clinic of UPTH. A self-administered questionnaire was used to obtain the clinico-demographic and psychosocial data.

Results: There were 97 (48.5%) males and 103 (51.5%) females in each group with a male to female ratio of 1:1.1. One hundred and fifty-eight (79.0%) subjects had a depressive feeling compared to 15 (7.5%) in the control group. One hundred and twenty two (61.0%) subjects avoided the health care system compared with 10 (5%) among the controls. Thirty nine (19.5%) subjects had social withdrawal compared with eight (4%) among the controls. Seventeen (8.5%) subjects had suicidal ideation compared with none among the control group. The prevalence of all four psychosocial complications assessed was significantly higher in the subjects compared with the controls.

Conclusion: Psychosocial complications are a major problem among adolescents with SCA. Regular psychosocial assessment is recommended for every SCA patient on follow up. Early detection and prompt psychological interventions are key to improving the quality of life in affected persons.