Comorbid depression in sickle cell disease: An overview of determinants and need for early detection

Sickle cell disease (SCD) is a chronic illness, characterized by periods of painful crises, frequent hospitalizations, and multiorgan dysfunction; patients are frequently exposed to diverse psychological stressors and insults which adversely impact on overall quality of life (QOL) and survival. The following key words: “sickle cell disease,” “psychological dysfunction,”, “psychopathology,” “co-morbid depression,” “quality of life,” “disease severity,” “treatment,” and “clinical outcome” were used for literature search on PubMed, PubMed Central, Google Scholar, African Index Medicus, and Scopus database sources. No limitation as to the year of publication was applied and the oldest paper retrieved was published in 1989. The search was restricted to depression occurring in the background of SCD and publications in English language. The studies retrieved dealt mainly on the epidemiology, etiopathogenesis, and treatment of co-morbid depression in SCD, whereas papers dealing primarily with depression not related to SCD were rejected. All papers identified were assessed by the authors with a view to highlighting the prevalence and effect of depression on the clinical course of SCD. Comorbid depression was shown to constitute a significant burden in subjects living with SCD; the prevalence of which increases with increasing disease severity. In affected SCD patients, it has adverse effects on QOL and disease course. The need for early detection of comorbid depression in patients with SCD is hereby emphasized, with a view to instituting appropriate treatment geared toward ameliorating its adverse effect on disease morbidity.