Sickle Cell Disease and Psychosocial Well-Being: Comparison of Patients With Preclinical and Clinical Avascular Necrosis of the Femoral Head

Özet

Aim: Sickle cell disease (SCD) has significant adverse psychosocial impacts in childhood.Patients with SCD may be affected by avascular necrosis (AVN) and the most commonlyinvolved site is the femoral head. We aimed to conduct a comparative investigation of the psychosocialwell-being of pediatric SCD patients with preclinical and clinical femoral head AVN.Materials and Methods: Patients with homozygous SCD and healthy peers aged 7-17 yearswere included in this cross-sectional study. Psychosocial well-being was assessed by theStrengths and Difficulties Questionnaire (SDQ), parent version. SDQ scores were comparedbetween the groups.Results: A total of 74 mother–child couples were enrolled in this study. The SCD with clinical AVN(stages I-IV) group consisted of 17 patients, SCD with preclinical AVN (stage 0) group consistedof 20 patients, and the control group consisted of 37 individuals. The sociodemographic characteristicsand medians of total difficulties, emotional problems, conduct problems, hyperactivity,and peer problems scores were not different between the 3 groups (P > .05). There was a significantdifference between the 3 groups in the prosocial score that indicates more positive socialbehaviors. Both groups, SCD with clinical AVN and with preclinical AVN, had lower prosocialscores than the control group (P .05).Conclusions: Pediatric patients with SCD, whether or not complicated with clinical AVN, hadlower prosocial scores than healthy peers. This study has presented the first comparison ofthe psychosocial well-being of pediatric SCD patients with preclinical and clinical femoralhead AVN.