Anxiety and depression in sickle cell anaemia: The impact of pain in a Nigerian population

Abstract

There is a dearth of information on depression and anxiety among Nigerian SCA population. This study objective was to determine the prevalence of depression and anxiety as well as establish their relationships with pain among a Nigerian population with SCA. This was a cross-sectional study that included 226 SCA individuals. A well-structured socio and clinical demographic questionnaire, Wong-Baker FACES pain rating scale, and Hospital Anxiety and Depression Scale (HADS) were data collection instruments utilized. The data were subjected to frequency distribution, cross-tab and logistic regression analyses in SPSS® v20 IBM, USA. Overall, 226 individuals with SCA including 111 males (49.1%) and 115 females (50.9%) with mean age 28.9 ± 8.5 years (range 16-50 years) were recruited into this study. The prevalence of anxiety and depression symptoms among Nigerian SCA cohort is 49.5% and 30.5% respectively. Additionally, about 70% and 46.0% of SCA individuals with pain had abnormal anxiety and depression score. Statistically significant chi-square value for anxiety (χ² = 58.573; Cramer's V = 0.509; P value = 0.000) and depression (χ²= 39.175; Cramer's V = 0.416; P value = 0.000) showed strong association with pain index. Logistic regression analysis revealed the odds of anxiety (OR = 3.430; 95% CI = 1.321-8.906; P value = 0.011) and depression (OR = 3.612; 95% CI = 1.251-10.427; P value = 0.018) event occurring with pain (relative to no pain). Finally, the prevalence of pain, anxiety and depression among Nigerian sickle cell anaemia cohort is high. Moreover, pain is a significant predictor of the risk of falling into anxiety and depression.