Skip to main content
SpringerLink
Log in

Depression and functioning in relation to health care use in sickle cell disease

  • Empirical Articles
  • Published:
Annals of Behavioral Medicine

Abstract

The purpose of the current study was to investigate depression and health care use in patients with sickle cell disease (SCD). Forty-four adults with SCD were interviewed and data from 43 participants, both with (n=11) and without (n=32) depression, were used for further analyses. Data from one potential subject were excluded on the basis of diagnosis. The full evaluation included the Structured Clinical Interview for DSM-III-R Disorders (SCID) and the Center for Epidemiologic Studies-Depression Scale (CES-D), as well as measures of psychosocial and behavioral functioning. Good between-instrument agreement was found between the self-report and interview-based measures of depression. However, the functioning data did not entirely support the use of a more stringent cutoff score on the CES-D. Findings suggest that the purpose of the evaluation should be factored into the decision-making process when determining which cutoff score should be utilized (i.e. what is the cost-benefit ratio for false-positives vs. false-negatives). A series of hierarchical regression analyses supported the finding that disease severity alone does not explain the level of functioning displayed by patients. More importantly, the patient's perceived functioning was the best indicator of health care use within a 1-year period. Furthermore, specific interventions that target negative thinking and distorted cognitions, as well as provide psychoeducation, such as cognitive-behavioral therapy, need to be further explored within this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Narrow WE, Regier DA, Rae DS, Manderscheid RW, Locke BZ: Use of services by persons with mental and addictive disorders: Findings from the National Institute of Mental Health Epidemiological Catchment Area Program.Archives of General Psychiatry. 1993,50:95–107.

    PubMed  CAS  Google Scholar 

  2. Gerber PD, Barrett J, Barrett J, et al: Recognition of depression by internists in primary: A comparison of internist and gold standard psychiatric assessments.Journal of General Internal Medicine. 1988,4(1):7–13.

    Article  Google Scholar 

  3. Perez-Stable EJ, Miranda J, Munoz RF, Ying YW: Depression in medical outpatients: Underrecognition and misdiagnosis.Archives of Internal Medicine. 1990,150(5):1083–1088.

    Article  PubMed  CAS  Google Scholar 

  4. Schulberg HC, Saul M, McClelland M, et al: Assessing depression in primary medical and psychiatric practices.Archives of General Psychiatry. 1985,42(12):1164–1170.

    PubMed  CAS  Google Scholar 

  5. Bukberg J, Holland JC: A prevalence study of depression in a cancer hospital population.Proceedings of the American Association of Cancer Research. 1980,21:382.

    Google Scholar 

  6. Dean C: Psychiatric morbidity following mastectomy: Preoperative predictors and types of illness.Journal of Psychosomatic Research. 1987,31:385–392.

    Article  PubMed  CAS  Google Scholar 

  7. Evans DL, McCartney CF, Nemeroff CB, et al: Depression in cancer patients: Diagnostic and treatment considerations.North Carolina Medical Journal. 1988,49(10):546–548.

    PubMed  CAS  Google Scholar 

  8. Finklestein S, Benowitz LI, Baldessarini RJ, et al: Mood, vegetative disturbance, and dexamethasone suppression test after stroke.Annals of Neurology. 1982,12(5):463–468.

    Article  PubMed  CAS  Google Scholar 

  9. Minden SL, Orav J, Reich P: Depression in multiple sclerosis.General Hospital Psychiatry. 1987,9(6):426–434.

    Article  PubMed  CAS  Google Scholar 

  10. Santamaria J, Tolosa E, Valles A: Parkinson's disease with depression: A possible subgroup of idiopathic parkinsonism.Neurology. 1986,36(8):1130–1133.

    PubMed  CAS  Google Scholar 

  11. Concensus Conference: Newborn screening for sickle cell disease and other hemoglobinopathies.Journal of the American Medical Association. 1987,258(9): 1205–1209.

    Article  Google Scholar 

  12. Charache S, Lubin B, Reid CD:Management and Therapy of Sickle Cell Disease. NIH Publication No. 84-2117. Washington, DC: U.S. Government Printing Office, 1992.

    Google Scholar 

  13. Gil KM: Coping with sickle cell disease pain.Annals of Behavioral Medicine. 1989,11(2):49–57.

    Article  Google Scholar 

  14. Kessler RC, McGonagle KA, Zhao S, et al: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey.Archives of General Psychiatry. 1994,51(1):8–19.

    PubMed  CAS  Google Scholar 

  15. Somervell PD, Leaf PJ, Weissman MM, Blazer DG, Bruce ML: The prevalence of major depression in Black and White adults in five United States communities.American Journal of Epidemiology. 1989,130(4):725–735.

    PubMed  CAS  Google Scholar 

  16. Barret DH, Wisotzek IE, Abel GG, et al: Assessment of psychosocial functioning of patients with sickle cell disease.Southern Medical Journal. 1988,81(6):745–750.

    Article  Google Scholar 

  17. Damlouji NF, Kevess-Cohen R, Charache S, Georgopoulos A, Folstein MF: Social disability and psychiatric morbidity in sickle cell anemia and diabetes patients.Psychosomatics. 1982,23(9):925–931.

    PubMed  CAS  Google Scholar 

  18. Thompson RJ, Gil KM, Abrams MR, Phillips G: Stress, coping, and psychological adjustment of adults with sickel cell disease.Journal of Consulting and Clinical Psychology. 1992,60(3):433–440.

    Article  PubMed  Google Scholar 

  19. Belgrave FZ, Molock SD: The role of depression in hospital admissions and emergency treatment of patients with sickle cell disease.Journal of the National Medical Association. 1991,83(9): 777–781.

    PubMed  CAS  Google Scholar 

  20. Schulberg HC, Burns BJ: Mental disorders in primary care: Epidemiologic, diagnostic, and treatment research directions.General Hospital Psychiatry. 1988,10(2):79–87.

    Article  PubMed  CAS  Google Scholar 

  21. Schaeffer JW, Gil KM, Burchinal M, et al: Depression, disease severity and sickle cell disease.Journal of Behavioral Medicine. 1999,22(2):115–126.

    Article  Google Scholar 

  22. Radloff LS: The CES-D scale: A self-report depression scale for research in the general population.Applied Psychological Measurement. 1977,1(3):385–401.

    Article  Google Scholar 

  23. Minden SL, Orav J, Reich P: Depression in multiple sclerosis.General Hospital Psychiatry. 1987,9(6):426–434.

    Article  PubMed  CAS  Google Scholar 

  24. Rucker L, Frye EB, Cygan RW: Feasability and usefulness of depression screening in medical outpatients.Archives of Internal Medicine. 1986,146(4):729–731.

    Article  PubMed  CAS  Google Scholar 

  25. Zich JM, Attkisson CC, Greenfield TK: Screening for depression in primary care clinics: The CES-D and the BDI.International Journal of Psychiatry in Medicine. 1990,20(3):259–277.

    PubMed  CAS  Google Scholar 

  26. Spitzer RL, Williams JBW, Gibbon M, First MB: The structured clinical interview for DSM-III-R (SCID), I: History, rationale and description.Archives of General Psychiatry. 1992,49:624–629.

    PubMed  CAS  Google Scholar 

  27. Malgady RG, Rogler LH, Tryon WW: Issues of validity in the Diagnostic Interview Schedule.Journal of Psychiatric Research. 1992,26(1):59–67.

    Article  PubMed  CAS  Google Scholar 

  28. Gil KM, Abrams MR, Phillips G, Keefe FJ: Sickle cell disease pain: Relation of coping strategies to adjustment.Journal of Consulting and Clinical Psychology. 1989,57(6):725–731.

    Article  PubMed  CAS  Google Scholar 

  29. Gil KM, Abrams MR, Phillips G, Williams DA: Sickle cell disease pain: 2. Predicting health care use and activity level at 9-month follow-up.Journal of Consulting and Clinical Psychology. 1992,60(2):267–273.

    Article  PubMed  CAS  Google Scholar 

  30. Blaney PH: Affect and memory: A review.Psychological Bulletin. 1986,99(2):229–246.

    Article  PubMed  CAS  Google Scholar 

  31. Williams JBW, Gibbon M, First MB, et al: The structured clinical interview for DSM-III-R (SCID).Archives of General Psychiatry. 1992,49:630–636.

    PubMed  CAS  Google Scholar 

  32. Robins LN, Helzer JE, Coughran J, Ratcliff KS: National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity.Archives of General Psychiatry. 1981,38(4):381–389.

    PubMed  CAS  Google Scholar 

  33. Riskind JH, Beck AT, Berchick RJ, Brown G, Steer RA: Reliability of DSM-III diagnoses for major depression and generalized anxiety disorder using the structured clinical interview for DSM-III.Archives of General Psychiatry. 1987,44(9):817–820.

    PubMed  CAS  Google Scholar 

  34. Skre I, Onstad S, Torgerson S, Kringlen E: High interrater reliability for the structured clinical interview for DSM-III-R axis I: SCID.Acta Psychiatrica Scandinavica. 1991,84:167–173.

    Article  PubMed  CAS  Google Scholar 

  35. Roberts RE: Reliability of the CES-D scale in different ethnic contexts.Psychiatry Research. 1980,2:125–134.

    Article  PubMed  CAS  Google Scholar 

  36. Weissman MM, Prusoff BA, Thompson WD, Harding PS, Myers JK: Social adjustment by self-report in a community sample and in psychiatric outpatients.Journal of Nervous and Mental Disease. 1978,166(5):317–326.

    Article  PubMed  CAS  Google Scholar 

  37. Weissman MM, Bothwell S: Assessment of social adjustment by patient self-report.Archives of General Psychiatry. 1976,33:1111–1115.

    PubMed  CAS  Google Scholar 

  38. Bergner M, Bobbitt RA, Carter WB, Gilson BS: The Sickness Impact Profile: Development and final revision of a health status measure.Medical Care. 1981,19(8):787–805.

    Article  PubMed  CAS  Google Scholar 

  39. Gil KM, Phillips G, Webster DA, et al: Experimental pain sensitivity and reports of negative thoughts in adults with sickle cell disease. Special Issue: Experimental pain as a model for the study of clinical pain.Behavior Therapy. 1995,26(2):273–293.

    Article  Google Scholar 

  40. Ohaeri JU, Campbell OB, Ilesanmil AO, Ohaeri BM: Psychosocial concerns of Nigerian women with breast and cervical cancer.Psycho-Oncology. 1998,7(6):494–501.

    Article  PubMed  CAS  Google Scholar 

  41. Bennett DS: Depression among children with chronic medical problems: A meta-analysis.Journal of Pediatric Psychology. 1994,19(2):149–169.

    Article  PubMed  CAS  Google Scholar 

  42. Keller MB, Lavori PW, Mueller TI, et al: Time to recovery, chronicity, and levels of psychopathology in major depression. A 5-year prospective follow-up of 431 subjects.Archives of General Psychiatry. 1992,49(10):809–816.

    PubMed  CAS  Google Scholar 

  43. Weissman MM, Klerman GL: The chronic depressive in the community: Unrecognized and poorly treated.Comprehensive Psychiatry. 1977,18(6):523–532.

    Article  PubMed  CAS  Google Scholar 

  44. McCrae JD, Lumley MA: Health status in sickle cell disease: Examining the roles of pain coping strategies, somatic awareness, and negative affectivity.Journal of Behavioral Medicine, 1998,21(1):35–55.

    Article  PubMed  CAS  Google Scholar 

  45. Solomon DA, Keller MB, Leon AC, et al: Recovery from major depression: A 10-year prospective follow-up across multiple episodes.Archives of General Psychiatry. 1997,54(11):1001–1006.

    PubMed  CAS  Google Scholar 

  46. Furakawa T, Hirai T, Kitamura T, Takahashi K: Application of the center for epidemiologic studies depression scale among first-visit psychiatric patients: A new approach to improve its performance.Journal of Affective Disorders. 1997,46:1–13.

    Article  Google Scholar 

  47. Firakawa T, Anraku K, Hiroe T, et al: Screening for depression among first-visit psychiatric patients: Comparison of different scoring methods for the center for epidemiologic studies depression scale using receiver operating characteristic analyses.Psychiatry and Clinical Neuroscience. 1997,51:71–78.

    Article  Google Scholar 

  48. Gil KM, Wilson JJ, Edens JL, et al: The effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease.Health Psychology. 1996,15:3–10.

    Article  PubMed  CAS  Google Scholar 

  49. Gil KM, Wilson JJ, Edens JL, et al: Cognitive coping skills training in children with sickle cell disease.International Journal of Behavioral Medicine. 1997,4:365–378.

    Article  Google Scholar 

  50. Wilson JJ, Gil KM, Raezer LB: Self-evaluation, coping and depressive affect in African American adults with sickle cell disease.Cognitive Therapy and Research. 1997,21:443–457.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, 15213, Pittsburgh, PA

    Merida M. Grant Ph.D.

  2. University of North Carolina at Chapel Hill, Chapel Hill, USA

    Karen M. Gil Ph.D.

  3. University of Virginia, Virginia, USA

    Marnita Y. Floyd M.A.

  4. Duke University Medical Center, Durham, USA

    Mary Abrams M.P.H.

Authors
  1. Merida M. Grant Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karen M. Gil Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marnita Y. Floyd M.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mary Abrams M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Preparation of this manuscript was supported in part by National Institutes of Health Grant RO1 HL46953-06, by Project VI.B.2 in the Duke University-University of North Carolina Sickle Cell Center Grant P60HL2839-12, and by the University of North Carolina at Chapel Hill General Clinical Research Center Grant RR00046. This research was also supported in part by the Fetzer Institute.

The authors acknowledge the contribution of the staff of the Duke University-University of North Carolina Sickle Cell Center including Daria Peace, Wendell Rosse, Thomas Kinney, Patricia Thomas, and Eugene Orringer.

About this article

Cite this article

Grant, M.M., Gil, K.M., Floyd, M.Y. et al. Depression and functioning in relation to health care use in sickle cell disease. ann. behav. med. 22, 149–157 (2000). https://doi.org/10.1007/BF02895779

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02895779

Keywords

Search

Navigation