Depression and anxiety in patients with sickle cell disease: conceptual and methodological considerations.

The literature suggests that a significant number of patients with sickle cell disease experience social and psychiatric impairment. Recently, a few investigators have focused on the role of depression in sickle cell disease. A review of this literature indicates that patients with sickle cell disease have a higher incidence of depression when compared to physically healthy controls. This relationship appears to be true even when the investigator controls for illness-related physical symptoms. This paper critically reviews the literature on the relationship between depression and sickle cell disease in African American patients, with particular emphasis on how depressive symptomatology affects treatment outcome (e.g., compliance, hospitalizations, etc.). The paper critically reviews this literature on both theoretical and methodological issues. Recommendations are also made with regards to both treatment and future research directions in this area.