Depression and Its Determinants Among Patients With Sickle Cell Disease: A Cross-Sectional Study

Abstract

Background: Depression among patients with sickle cell disease (SCD) is crucial as it is often underdiagnosed and undertreated. Therefore, this study aimed to determine the prevalence of depression and to identify its determinants.

Methods: This cross-sectional study was conducted in the Bardiya district of Nepal, based on registered cases of SCD. Depression was measured using the validated Nepalese version of the Beck Depression Inventory (BDI). A random sample of 358 participants with SCD aged >13 years was included in the study. Descriptive and inferential statistics were applied to sociodemographic, clinical and psychological variables. Logistic regression analysis was performed for bivariate analysis. Variables with a p value of less than 0.05 were subjected to final multivariate logistic regression.

Results: The prevalence of depression was 36.31% among patients with SCD, age (p = 0.0178), education (p = 0.0178) and sociodemographic status (p = 0.0328) were strongly associated. Factors such as patients aged 40-49 years (adjusted odds ratio [AOR] = 3.05), complications due to SCD (AOR = 1.86) and genetic counselling group (AOR = 4.72) had higher chances of experiencing depression compared to their relative counterparts. However, patients with lower middle-class economic status, who experience pain crisis, with moderate self-esteem and who experience discrimination were 52%, 83%, 58% and 58% less likely to have depression compared to their respective counterparts, respectively.

Conclusions: Depression was prevalent in patients with SCD, and multiple sociodemographic, clinical and psychological factors were strongly associated. This warrants the urgent need for early diagnosis and treatment of depression among participants with SCD.

Keywords: depression; low‐resource setting; sickle cell disease; socioeconomic status.