Religiosity, Anxiety, Depression, and Suicidal Ideation in Brazilian Patients with Sickle Cell Disease

Abstract

Introduction: Sickle cell disease (SCD) is an inherited hemoglobinopathy that can evolve with time, in some individuals, as a debilitating chronic pain syndrome with emotional dysfunctions. Objective: To evaluate different types of religiosities: organizational (ORA), non-organizational (NORA), and intrinsic religiosity (IR), and their correlation with mental health in individuals with SCD. The variables analyzed were depression, anxiety, and catastrophic and suicidal thoughts. Method: This is a descriptive cross-sectional study, which is part of a crossover randomized clinical trial. We recruited adults among individuals with SCD from Bahia-Brazil. We used: Duke's religiosity index, Hospital Anxiety and Depression Scale (HADS), and Brazilian Portuguese Pain Catastrophizing Scale (BP-PCS) data. The Spearman correlation and Fisher exact test were used for statistics considering alpha 95%. Results: Of the 131 individuals approached for participation, 75 completed all questionnaires with genotype HbSS and HbSC. Of them, 49 (65,3%) were women, with an average age of 34.13 +10.02, 66 (88.0%) self-declared black, 63 (84.0%) declared to belong to a religious group, 67 (89.3%) with a high form of religious involvement. The mean of intense pain was 3.86 + 2.74; 40 (53.33%) had anxiety, 25 (33.33%) had depression, and 15 (20.0%) declared having suicidal thoughts. There was a negative correlation between depression and IR (r = -0.240, p = 0.038) and a correlation between average pain and NORA (r = 0.301, p = 0.009). An association between NORA and chronic pain was verified (p = 0.023), OR (p < 0.001), NORA (p = 0.042), and IR (p = 0.004) with evangelical SCD subjects. Conclusion: This study highlights the need for mental health care in patients with SCD due to the high rates of anxiety and depression, with the need to include religiosity since it is a frequent and important element in the lives of people with SCD.