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镰状细胞病中的抑郁症

Depression in sickle cell disease.

作者信息

Hasan Syed Parwez, Hashmi Shahzad, Alhassen Mohammed, Lawson William, Castro Oswaldo

机构信息

Center for Sickle Cell Disease, Howard University Hospital, Washington, DC 20059, USA.

出版信息

J Natl Med Assoc. 2003 Jul;95(7):533-7.

Abstract

PURPOSE

To assess the prevalence of depressive symptoms and examine the contribution of demographics, disease severity, and health care use variables to depressive symptoms in sickle cell patients who had been in stable health for at least one month.

PATIENTS AND METHODS

Subjects were a convenience sample of 27 men and 23 women selected during a routine visit to the sickle cell clinic at Howard University Hospital. Depression was assessed using a cut-off score from the Beck Depression Inventory (BDI) and related to a variety of health outcomes.

RESULTS

The results of the analyses indicate that 44% (n=22) of the sample scored within the mild to severe (>20) range of depression on the BDI. Depressed sickle cell patients were more frequently treated in emergency rooms and more likely to be hospitalized with vaso-occlusive crises. Patients more likely to be depressed were: those with low family income (<$10,000); less than high school education; female; those who had multiple blood transfusions; poor pain control; inadequate social support; hydroxyurea use; and had histories of frequent vaso-occlusive crises.

CONCLUSION

The prevalence of depressive symptoms in sickle cell patients is high compared to the general African American population. Our findings confirmed previous studies examining the occurrence of depression in adults with sickle cell disease. Treatment of depression should be strongly considered to improve the quality of life and probably disease course in sickle cell patients.

摘要

目的

评估抑郁症状的患病率,并研究人口统计学、疾病严重程度和医疗保健使用变量对至少一个月来健康状况稳定的镰状细胞病患者抑郁症状的影响。

患者与方法

研究对象是在霍华德大学医院镰状细胞病诊所常规就诊期间选取的27名男性和23名女性的便利样本。使用贝克抑郁量表(BDI)的临界值评估抑郁情况,并将其与多种健康结果相关联。

结果

分析结果表明,样本中有44%(n = 22)的人在BDI上的抑郁得分处于轻度至重度(>20)范围。抑郁的镰状细胞病患者在急诊室接受治疗的频率更高,因血管阻塞性危机住院的可能性也更大。更易出现抑郁的患者包括:家庭收入低(<10,000美元);未接受过高中教育;女性;接受过多次输血;疼痛控制不佳;社会支持不足;使用羟基脲;以及有频繁血管阻塞性危机病史的患者。

结论

与一般非裔美国人群相比,镰状细胞病患者中抑郁症状的患病率较高。我们的研究结果证实了先前关于镰状细胞病成人患者抑郁发生率的研究。应强烈考虑对抑郁进行治疗,以改善镰状细胞病患者的生活质量,并可能改善疾病进程。

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