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Psychiatric complications of homozygous sickle cell disease among young adults in the Jamaican Cohort Study

Published online by Cambridge University Press:  02 January 2018

Claire Hilton*
Affiliation:
University of Manchester
Madeline Osborn
Affiliation:
Department of Psychiatry, Ysbyty Gwynedd, Bangor, Wales
Susan Knight
Affiliation:
MRC Sickle Cell Laboratories (Jamaica) and Department of Child Health, University ofthe West Indies, Kingston, Jamaica
Atul Singhal
Affiliation:
MRC Sickle Cell Laboratories (Jamaica), University of the West Indies, Kingston, Jamaica
Graham Serjeant
Affiliation:
MRC Sickle Cell Laboratories (Jamaica), University of the West Indies, Kingston, Jamaica
*
Dr C. Hilton, Elderly Services, Mental Health Services of Salford, Bury New Road, Prestwich, Manchester M25 3BL

Abstract

Background

This study aimed to determine the prevalence of psychiatric disorder in young adults with homzygous sickle cell (SS) disease and in controls with normal haemoglobin, and to examine factors associated with psychiatric disorder.

Method

The study design was cross-sectional. Subjects were aged 18–20 years: 63 with SS disease and 89 controls. The Psychiatric Assessment Schedule was used to determine psychiatric disorder at index of Definition level 5.

Results

Psychiatric disorder was identified in 18 (29%) SS disease patients and in 22 (25%) controls. In SS patients, psychiatric disorder was not related to illness severity but was associated with leaving school early, difficulties in social adjustment, impaired cognitive function and having previous psychiatric difficulties. Male SS patients with psychiatric disorder all had low body mass index (BMI < 17.60). In controls, psychiatric disorder was associated with female gender, unemployment and difficulties in social adjustment.

Conclusions

The prevalence of psychiatric disorder was similar in patients and controls, although associated factors tended to be different. The association with low BMI in SS men merits further study.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Abas, M., Broadhead, J. C., Mbape, P., et al (1994) Defeating depression in the developing world: A Zimbabwean model. One country's response to the challenge. British Journal of Psychiatry 164, 293296.CrossRefGoogle Scholar
Achenbach, T. & Edelbrock, C. (1983) Manual for the Child Behaviour Checklist and Revised Child Behaviour Profile. Burlington. VT: University of Vermont.Google Scholar
Alieyne, S., Wint, E. & Serjeant, G. (1977) Social effects of leg ulceration in sickle cell anaemia. Southern Medical Journal. 70, 213214.CrossRefGoogle Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders(3rd edn. revised) (DSM-III-R). Washington. DC: APA.Google Scholar
Barrett, D. Wizotzek, I., Gene, A., et al (1988) Assessment of psychosocial functioning of patients with sickle cell disease. Southern Medical Journal, 81, 745750.CrossRefGoogle ScholarPubMed
Bebbington, P., Hurry, J., Tennant, C., et al (1981) Epidemiology of mental disorders in Camberwell. Psychological Medicine, 11, 561579.CrossRefGoogle ScholarPubMed
Bebbington, P., Hurry, J. & Tennant, C. (1991) The Camberwell community survey: a summary of results. Social Psychiatry and Psychiatric Epidemiology 26, 195201.CrossRefGoogle ScholarPubMed
Belgrave, F. & Mollock, S. (1991) The role of depression in hospital admissions and emergency treatment of patients with sickle cell disease. Journal of the National Medical Association, 83, 777781.Google ScholarPubMed
Bridges, K. W. & Goldberg, D. P. (1984) Psychiatric illness in inpatients with neurological disorders: patients views on discussion of emotional problems with neurologists. British Medical Journal. 286, 656658.CrossRefGoogle Scholar
Brown, G. W. & Harris, T. (1978) Social Origins of Depression. A Study of Psychiatric Disorder in Women. London: Tavistock.Google Scholar
Brugha, T., Bebbington, P., Tennant, C., et al (1985) The list of threatening experiences: a subset of 12 life event categories with considerable long term contextual threat. Psychological Medicine. 15, 189194.CrossRefGoogle ScholarPubMed
Cooper, P., Osborn, M., Gath, D., et al (1982) Evaluation of a modified self-report measure of social adjustment. British Journal of Psychiatry. 141, 6875.CrossRefGoogle ScholarPubMed
Cowen, L., Corey, M., Simmons, R., et al (1984) Growing older with cystic fibrosis: psychologic adjustment of patients more than 16 years old. Psychosomatic Medicine, 46, 363376.CrossRefGoogle Scholar
Damlouji, N., Kevess-Cohen, R., Charache, S., et al (1982) Social disability and psychiatric morbidity in sickle cell anaemia and diabetes patients. Psychosomatics, 23, 925931.CrossRefGoogle ScholarPubMed
Dean, C., Surtees, P. G. & Sashidharan, S. P. (1983) Comparison of research diagnostic systems m an Edinburgh community sample. British Journal of Psychiatry 142, 247256.CrossRefGoogle Scholar
Gil, K. M., Phillips, G., Abrams, M. R., et al (1990) Pain drawings and sickle cell disease pain. Clinical Journal of Pain, 6, 105109.CrossRefGoogle ScholarPubMed
Goldberg, D. P. & Hillier, V. F. (1979) A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139145.CrossRefGoogle ScholarPubMed
Goldberg, D. P., Hillier, V. F. & Williams, P. (1988) A Users Guide to the General Health Questionnaire, Windsor: NFER-Nelson.Google Scholar
Goodchild, M. E. & Duncan-Jones, P. (1985) Chronicity and the General Health Questionnaire. British Journal of Psychiatry 146, 5561.CrossRefGoogle ScholarPubMed
Greer, S. (1991) Psychological response to cancer and survival. Psychological Medicine, 21, 4349.CrossRefGoogle ScholarPubMed
Hurtig, A. L. & Park, K. (1989) Adjustment and coping in adolescents with sickle cell disease. Annals of the New York Academy of Sciences. 565, 172182.CrossRefGoogle ScholarPubMed
Knight, S., Singhal, A., Thonnas, P., et al (1995) Factors associated with lowered intelligence in homozygous sickle cell disease. Archives of Disease in Chiklhood. 73, 316320.CrossRefGoogle ScholarPubMed
Kumar, S., Powars, D., Allen, J., et al (1976) Anxiety self concept and personal and social adjustments in children with sickle cell anaemia, Journal of Pediatrics, 88, 859863.CrossRefGoogle Scholar
Lee, A., Thomas, P., Cupidore, L., et al (1995) Improved survival in homozygous sickle cell disease: lessons from a cohort study British Medical Journal. 311, 16001602.CrossRefGoogle ScholarPubMed
Lezak, M. D. (1976) Neuropsychological Assessment. Oxford: Oxford University Press.Google Scholar
Lishman, W. A. (1987) Organic Psychiatry 2nd edn. Oxford: Blackwell Scientific.Google Scholar
Mayou, R. & Hawton, K. (1986) Psychiatric disorder in the general hospital. British Journal of Psychiatry 149, 172190.CrossRefGoogle ScholarPubMed
Morgan, S. & Jackson, J. (1986) Psychological and social concomitants of sickle cell anaemia in adolescents. Journal of Pediatric Psychology II 429440.CrossRefGoogle Scholar
Nadel, C. & Portadin, G. (1977) Sickle cell crises: psychological factors associated with onset. New York State Journal of Medicine. 77, 10751078.Google ScholarPubMed
Rothman, K. J. (1980) No adjustments are needed for multiple comparisons. Epidemiology 1, 4350.CrossRefGoogle Scholar
Royal College of Physicians and Royal College of Psychiatrists (1995) The Psychological Care of Medical Patients: Recognition of Need and Service Provision. London: Royal College of Physicians and Royal College of Psychiatrists.Google Scholar
Sergeant, G. R., Serjeant, B. E., Forbes, M., et al (1986) Haemoglobin gene frequencies in the Jamaican population: A study of 100 000 newborns. British Journal of Haematology 64, 253262.CrossRefGoogle Scholar
Smith, M G. (1984) Culture Race and Oass in the Commonwealth Canbbean. Mona, Kingston, Jamaica: School of Continuing Studies. University of the West Indies.Google Scholar
STATIN (1990) Jamaica Survey of Living Conditions 1989. Kingston. Jamaica: Statistical Institute of Jamaica.Google Scholar
Streetley, A., Dick, M. & Layton, M. (1993) Sickle cell disease: the case for coordinated information. British Medical Journal. 306, 14911492.CrossRefGoogle Scholar
Swift, A. V., Cohen, M. J., Hynd, G. W., et al (1968) Neuropsychologic imparment in children with sickle cell anemia. Pediatrics, 84, 10771085.CrossRefGoogle Scholar
Thompson, R., Gil, K., Abraim, M., et al (1992) Stress, coping and psychological adjustment of adults with sickle cell disease, Journal of Consulting and Omical Psychohgy 60, 433440.Google ScholarPubMed
Walco, G., & Dampier, C. (1987) Chronic pain in adolescent patients. Journal of Pediatric Psychdogy 12, 215225.CrossRefGoogle ScholarPubMed
Wasserman, A. L., Wilimas, J. A., Fairdough, D. L., et al (1991) Subtle neuropsychological deficits in children with sickle cell disease. American Journal of Pediatric Hematology and Oncology 13, 1420.CrossRefGoogle ScholarPubMed
Wachsler, D. (1945) A standardised memory scale for clinical use. Journal of Psychology 19, 8795.CrossRefGoogle Scholar
Weissman, M. M. & Klerman, G. L. (1977) Sex differences in the epidemiology of depression. Archives of General Psychiatry 34, 98111.CrossRefGoogle ScholarPubMed
Wilson, B. A., Cockbum, J. & Baddeley, A. D. (1985) The Rivermead Behavioural Memory Test. Bury St Edmunds: Thannes Valley Test Co.Google Scholar
Wing, J. K., Cooper, J. E., & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. An Instruction Manual for the PSE and CATEGO Program. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K., & Sturt, E. (1978) The PSE-ID-CATEGO System: A Supplementary Manual. London: Institute of Psychiatry.Google Scholar
World Health Organization (1975) Schizophrenia: A Multinational Study Geneva. Switzerland: WHO.Google Scholar
World Health Organization (1992) The ICD-IO Classification of Mental and Behavioural Disonjers. Qinical descriptions and diagnostic guidelines. Geneva. Switzerland: WHO.Google Scholar
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