Kelly Harris|Taniya Varughese|Anna Bauer|Seth Howdeshell|Cecelia Calhoun|Regina Abel|Allison A. King
The Relationship between Mental Health, Educational Attainment, Employment Outcomes, and Pain in Sickle Cell Disease
Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis
sickle cell disease scd common genetic condition world disproportionately affects african americans families lower household incomes scd characterized variety complications including episodes severe pain chronic anemia endorgan damage morbidity scd begins infancy increases frequency severity age complications childhood adolescence critical learning periods youth substantially impact educational attainment life outcomes scdrelated hospitalizations associated social determinants health socioeconomic status ses depression health literacy educational outcomes youth scd family neighborhood ses predictors pain level pain frequency overall quality life addition physiological impacts scd individuals scd experience emotional stress related effects disease may impact daily quality life frequency severity pain studies found hospital admission frequency limited impact academic outcomes youth scd studies explicitly examined relationship scdrelated pain educational socioeconomic mental health outcomes crosssectional study patient survey data single site sickle cell disease implementation science consortium scdic primary objective identify relationship educational attainment employment status mental health frequency severity length pain crises individuals scd multivariate analysis used assess impact patients educational attainment employment status annual household income low less 25000 high 75001 selfreported depression frequency length severity scdrelated pain central hypothesis individuals history depression lower educational attainment periods unemployment lower incomes experience frequent severe longer pain crises total 307 participants included mean age 274 years range 15 45 583 female 99 african american sixtytwo percent hgb ss severe form scd half patients 505 reported take pain medication every day scd majority form disease modification 642 hydroxyurea hu 202 chronic blood transfusion slightly less half 489 reported highest level education high school diploma lower unemployed 153 students 228 disabled 215 592 reported average annual household income less 25000 univariate analysis revealed statistically significant associations employment status unemployed disabled frequency pain p amplt 001 employment status unemployed disabled severity pain p amplt 001 employment status disabled length pain ampgt 4 days relationships depression frequency severity pain statistically significant p amplt 001 level depression length pain ampgt 1 week p amplt 01 level multivariate analysis revealed positive statistically significant relationships depression high pain frequency p amplt 001 employment status disabled severe pain p amplt 01 depression severe pain p amplt 01 employment status disabled length pain ampgt4 days p amplt 05 table 1 educational attainment demonstrate statistically significant relationships pain outcomes variables demonstrated statistically significant relationships length pain ampgt 1 week length pain ampgt 2 weeks significant association pain outcomes hu users less likely take daily opioids individuals scd disabled history depression likely report severe frequent pain relationship emerged educational attainment pain outcomes results limited crosssectional design cannot make statements causality know people scd risk factors need study interventions plan assess study participants across eight scdic sites next phase work disclosures king bioline consultancy amphivena therapeutics research funding incyte consultancy cell works consultancy celgene consultancy magenta therapeutics membership entitys board directors advisory committees novimmune research funding rivervest consultancy tioma therapeutics formerly vasculox inc consultancy wugen equity ownership