Prevalence and Determinants of Depression Among the Patients with Sickle Cell Disease: Pilot Study

Author's Information:

Bhuwan Dahit

Patan Academy of HealthScience, Lalitpur, Nepal

Madhusudan Subedi

Patan Academy of HealthScience, Lalitpur, Nepal

Yujin Kushmi

Institute of Medicine, Tribhuvan University, Nepal

Aitawari Chaudhari

Health Section, Nepalganj Sub Metropolitan City, Banke, Nepal

Vol 5 No 12 (2025):Volume 05 Issue 12 December 2025

Page No.: 313-319

Abstract:

Background: Depression and its determinants among the patients with sickle cell disease (SCD) is a complicated issue in low resource setting like Nepal. The objective of this study is to determine the prevalence of depression and its determinants among the patients with SCD in community.

Methods: A cross sectional study based on community setting was conducted among randomlyselected 40 patients. Bio-psycho-socialmodel was taken to understand the phenomena of depression and its determinants. Validated nepali version Beck Depression Inventory(BDI) was used to determine prevalence of depression among patients with SCD. Standard questionnaires, Rosenberg self-esteem scale and Multidimensional scale of Perceived Social support (MSPSS) were used to identify determinants of depression.

Results: Prevalence of depression among patients with SCD was found 32.5%, in which5% had severe depression using BDI scale. Depression was found associated with average family income, blood transfusion, self-esteem, difficulties for access to specialized doctor, and means of transportation amongthe patients.

Conclusion: One out of three patients with SCD are suffering from depression. Biological, psychological and social factors were the contributing factors for developing depression among people with SCD. Hence, it is therefore important to assess and treat depression among all patients with sickle cell disease to improve their mental and overall health. The validated tools were used for further study also.

KeyWords:

depression, sickle cell disease, Tharu, Nepal

References:

  1. Marcus M, Yasamy MT, van OmmerenM van, Chisholm D, Saxena S. Depression: A GlobalPublic Health Concern. 2012; Available from: https://psycnet.apa.org/doi/10.1037/e517532013-004
  2. James SL, Abate D, Abate KH, Abay SM, AbbafatiC, Abbasi N, et al. Global, regional,and national incidence, prevalence, and years lived with disability for 354diseases and injuriesfor 195 countries and territories, 1990– 2017: a systematic analysis for the Global Burden of Disease Study 2017. The lancet. 2018;392(10159):1789– 858. Available from: https://doi.org/10.1016/S0140-6736(18)32279-7
  3. Sandmire HF, AustinSD, Bechtel RC. Experience with 40,000 Papanicolaou smears. Obstetrics and Gynecology. 1976;48(1):56–60. Available from: https://pubmed.ncbi.nl m.nih.gov/934574/
  4. Rees DC, WilliamsTN, Gladwin MT. Sickle-cell disease. The Lancet. 2010;376(9757):2018–31. Available from: https://doi.org/10.1016/s0140-6736(10)61029-x
  5. Brown T. Major Depressive Disorder and Sickle Cell Anemia: Bidirectional Comorbidities. Hematology & Transfusion International Journal.2016;2(3):58–9. Available from: https://doi.org/10.15406/htij.2016.02.00039
  6. Anim MT, Osafo J, Yirdong F. Prevalence of psychological symptomsamong adults with sickle cell disease in Korle-Bu Teaching Hospital, Ghana. BMC psychology. 2016;4(1):53. Available from: https://doi.org/10.1186/s40359-016-0162-z
  7. Alao AO, Dewan MJ, Jindal S,Effron M. Psychopathology in sickle cell disease. West African journal of medicine. 2003;22(4):334–7. Available from: https://doi.org/10.4314/wajm.v22i4.28059
  8. Tartt KL, Appel SJ, Mann-Jiles V, Demonbreun K, John LI. An integrative review of sicklecell and depression. International Archives of Nursing and Health Care. 2015;1(20):1–7. Available from: http://doi.org/10.23937/2469-5823/1510020
  9. Salihu AS, Udofia O. Prevalence and associated factorsof depression among general outpatients in a tertiary institution in Kano, North-Western Nigeria. Open Journal of Psychiatry. 2016;6(3):228–36. Available from: http://dx.doi.org/10.4236/ojpsych.2016.63028
  10. Pegelow CH. Strokein children with sickle cell anaemia: aetiology and treatment. Paediatric drugs. 2001;3(6):421–32. Available from: https://doi.org/10.2165/00128072-200103060-00003
  11. Sehlo MG, Kamfar HZ. Depression and quality of life in children with sickle cell disease: the effect of social support. BMC psychiatry. 2015;15(1):78. Available from: https://doi.org/10.1186/s12888-015-0461-6
  12. Karki KB, Thapa P, Dhimal M, Bista B, Joshi A, Poudyal A, et al. Anemia and its Determinants among Women of Reproductive Age in Mid-Western Tarai of Nepal 2015 [Internet]. Nepal Health ResearchCouncil; 2016. Available from: http://103.69.126.140:8080/handle/20.500.14356/762
  13. Pande R, Ghimire PG, Chand PB, Gupta S. Sickle cell disease in Western Nepal.Nepal Journal of Medical Sciences. 2019;4(1):15–9. Available from: https://doi.org/10.3126/njms.v4i1.24121
  14. Yawn BP, Buchanan GR, Afenyi-Annan AN, Ballas SK, Hassell KL, James AH, et al. Management of sickle cell disease: summary of the 2014 evidence-based reportby expert panel members. Jama. 2014;312(10):1033–48.Available from: doi:10.1001/jama.2014.10517
  15. Kohrt BA, KunzRiD, Koirala NR, Sharma VD, Nepal MK. Validation of a Nepali version of the Beck Depression Inventory. Nepalese Journal of Psychiatry. 2002;2(4):123–30. Available from: https://www.researchgate.net/publication/285869290_Validation_of_a_Nepali_version_of_the_Beck_Depressio n_Inventory
  16. Tulachan P, Lama PY, Upadhyaya S, Pant SB, Chapagai M, Dhungana S. Translation, adaptation and validation of Nepali version of Rosenberg self esteem scale in adult Nepali population. SSM-Mental Health. 2022;2:100150. Available from: https://doi.org/10.1016/j.ssmmh.2022.100150
  17. Tonsing K, Zimet GD, Tse S. Assessing social support among South Asians:The multidimensional scale of perceived social support. Asian journal of psychiatry. 2012;5(2):164–8. Available from: https://doi.org/10.1016/j.ajp.2012.02.012
  18. RAJI S, LAWANIA, JAMES B. Determinants of quality of life in adults with sickle cell disease in Benin-City, Nigeria: cross-sectional study. Nigerian Journal of Psychiatry. 2024;15(1):44–44. Available from: https://nigerianjournalofpsychiatry.com/?mno=198696
  19. Joshi SK, Acharya K. Modification of Kuppuswamy’s socioeconomic status scale in the context of Nepal, 2019. Available from: https://www.researchgate.net/publication/334697550_Modification_of_Kuppuswamy%27s_Socioeconomic_St atus_Scale_in_the_Context_of_Nepal_2019
  20. Charan J, Biswas T. How to calculate sample size for differentstudy designs in medical research? Indian journal of psychological medicine. 2013;35(2):121–6. Available from: https://doi.org/10.4103/0253- 7176.116232
  21. Jha AK, Ojha SP, Dahal S, Sharma P, Pant SB, LabhS, et al. Prevalence of mental disorders in Nepal: findings from the pilot study. 2019; Available from: http://103.69.126.140:8080/handle/20.500.14356/1375
  22. Thapa S, Lamichhane N, Mishra DK. Depression among people living with type II diabetes in kathmandu valley of nepal: A crosssectional study. Available from: https://www.researchgate.net/publication/354574075_Depression_among_People_Living_with_Type_II_Diabet es_in_Kathmandu_Valley_of_Nepal_A_Cross-_Sectional_Study
  23. Thapa P, Rawal N, Bista Y. A study of depression and anxiety in cancer patients. Nepal Medical College journal: NMCJ. 2010;12(3):171–5. Available from: https://www.researchgate.net/publication/50905999_A_study_of_depression_and_anxiety_in_cancer_patients
  24. Manandhar NR, Shakya R, Pandey B, Wagley P. Depression among patients undergoing maintenance hemodialysis at a tertiary care center in Kathmandu, Nepal. Journal of Patan Academy of Health Sciences. 2018;5(2):4–11. Available from: https://doi.org/10.3126/jpahs.v5i2.23982
  25. Neupane D, Panthi B, McLachlan CS, Mishra SR, Kohrt BA, Kallestrup P. Prevalence of undiagnosed depression among persons with hypertension and associated risk factors: a cross-sectional study in urbanNepal. PloS one. 2015;10(2):e0117329. DOI: 10.1371/journal.pone.0117329
  26. Al-Hajeri A, Saleh L, Ali M, Alkowari S, Langawi J. Prevalence of depression among patients with sickle cell disease in Bahrain. 2017; DOI: 10.26715/jbms.29.3.2017.46a
  27. Alsubaie SS, AlmathamiMA, Abouelyazid A, Alqahtani MM. Prevalence of depression among adults with sickle cell disease in the southernregion of Saudi Arabia. Pakistanjournal of medical sciences. 2018;34(4):929. DOI: 10.12669/pjms.344.14760
  28. Raji SO, LawaniAO, James BO. Prevalence and correlates of major depression among Nigerian adults with sickle cell disease. The International Journal of Psychiatry in Medicine. 2016;51(5):456–66. DOI: 10.1177/0091217416680839
  29. Mubangizi I, Nakimuli-Mpungu E, Kawooya I, Sekaggya-wiltshire C. Prevalence And Factors Associated With Depression Among Adults With Sickle Cell Disease at Mulago Hospital, Uganda: a Cross Sectional Study [Internet]. Research Square; 2020 [cited 2025 Nov 24]. Available from: https://www.researchsquare.com/article/rs-104883/v1
  30. Adam SS, Flahiff CM, Kamble S, Telen MJ, Reed SD, De Castro LM. Depression, qualityof life, and medical resource utilization in sickle cell disease. Blood Adv. 2017 Oct 12;1(23):1983–92. DOI: 10.1182/bloodadvances.2017006940