Abstract
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Abstract; BACKGROUND; ; Depression among patients with sickle cell disease (SCD) is under diagnosed and undertreated due to the overlap of symptoms and signs of SCD and depression. The study sought to determine the prevalence and factors associated with depression among adults attending the SCD out-patient clinic in Mulago Hospital, Uganda.; METHODS; ; This was a cross sectional study in which 255 adults with SCD were enrolled. Participants were evaluated for depression using the Self Report Questionnaire (SRQ-20) and a score of 6 was considered diagnostic of depression. Demographic data was collected with a pre-tested study questionnaire. Perceived social support was measured using the 12-item multidimensional social support scale and, self-esteem was measured using the Rosenberg Self-Esteem Scale. Blood samples were taken to obtain a complete blood count. Modified poisson regression analyses were used to determine associations of depression.; RESULTS; ; The prevalence of depression was 68.2% (95% C.I; 62–74) with a median age of 21 years. The factors independently associated with depression were pain crisis in the last month (prevalence ratio (PR) = 1.07, 95% CI: 1.04–1.07, p = 0.001), history of a hospital admission in the past 6 months (PR = 1.04, 95% CI: 1.01–1.07, p = 0.012), formal education (PR = 0.79, 95% CI: 0.59–0.97, P = 0.008) and a low social support rating (PR = 0.67, 95% CI: 0.53–0.84, P = 0.0019); CONCLUSIONS; ; The prevalence of depression in adults with SCD is high with up to two thirds of patients having some form of depression. The major risk factors were low level of education, low social support, pain crises in the past month and hospital admissions in the last 6 months.