Sickle Cell Unit, Tropical Medicine Research Institute, University of the West Indies, Mona Campus, Kingston 6, Jamaica
BMC Psychiatry. 2010 Jun 7;10:40. doi: 10.1186/1471-244X-10-40.
Sickle cell disease (SCD) is the commonest genetic disorder in Jamaica, and has life-long implications for those afflicted with it. It is well known that depression and loneliness may exist in those with chronic diseases, but the coexistence of depression and loneliness in people with sickle cell disease is not clear. The aim of this study is to determine the prevalence of and factors associated with depression and loneliness in the Jamaica Sickle Cell Cohort Study and its age and sex matched controls.
277 patients with SCD and 65 controls were administered a questionnaire that studied demographics, disease severity, depression, and loneliness. Regression analyses were done to examine relationships between outcomes and associated variables.
Depression was found in 21.6% of patients and 9.4% in controls. Loneliness scores were also significantly higher in patients (16.9 +/- 5.1) than in controls (14.95 +/- 4.69). Depression was significantly associated with unemployment [OR = 2.9, p-value: < 0.001], whereas unemployment (p-value: 0.002), and lower educational attainment were significantly associated with loneliness.In patients with SCD, depression was significantly associated with being unemployed (OR 2.4, 95% CI 1.2,4.6, p-value:0.01), presence of a leg ulcer (OR = 3.8, 95% CI: 1.7, 8.4, p-value: 0.001), frequent visits (OR = 3.3, 95% CI: 1.2, 8.9, p-value: 0.019), and frequent painful crises (OR = 2.5, 95% CI: 1.1, 5.8, p-value: 0.035). Not being employed (Coef.: 2.0; p-value: 0.004) and higher educational attainment (tertiary vs. primary education, Coef.: -5.5; p-value: < 0.001) were significant associations with loneliness after adjusting for genotype.
Health workers need to actively look for and manage these problems to optimize their patients' total biopsychosocial care.
镰状细胞病（SCD）是牙买加最常见的遗传疾病，对患病者的一生都有影响。众所周知，慢性疾病患者可能会感到抑郁和孤独，但 SCD 患者的抑郁和孤独是否同时存在尚不清楚。本研究旨在确定牙买加镰状细胞队列研究及其年龄和性别匹配对照中抑郁和孤独的患病率及其相关因素。
对 277 名 SCD 患者和 65 名对照进行问卷调查，调查内容包括人口统计学、疾病严重程度、抑郁和孤独。回归分析用于检查结局与相关变量之间的关系。
患者中抑郁的发生率为 21.6%，对照组为 9.4%。患者的孤独评分（16.9 +/- 5.1）也明显高于对照组（14.95 +/- 4.69）。失业与抑郁显著相关[比值比（OR）=2.9，p 值：< 0.001]，而失业（p 值：0.002）和较低的教育程度与孤独显著相关。在 SCD 患者中，失业（OR 2.4，95%CI 1.2，4.6，p 值：0.01）、腿部溃疡（OR = 3.8，95%CI：1.7，8.4，p 值：0.001）、就诊频率（OR = 3.3，95%CI：1.2，8.9，p 值：0.019）和疼痛发作频率（OR = 2.5，95%CI：1.1，5.8，p 值：0.035）与抑郁显著相关。调整基因型后，未就业（系数：2.0；p 值：0.004）和较高的教育程度（与小学教育相比，高等教育，系数：-5.5；p 值：< 0.001）与孤独显著相关。
卫生工作者需要积极寻找并处理这些问题，以优化患者的整体生物心理社会护理。
