Determinants of Depression and Suicidality Among Adolescents with Sickle Cell Disease in Kano, Nigeria

Background: Despite the reported high magnitude of depression and suicidality among adolescents with sickle cell disease (SCD), the evidence bases in Nigeria particularly Northern Nigeria is sparse. The study assessed the prevalence and determinants of depression and suicidality among adolescents attending sickle cell clinic of Murtala Muhammad Specialist Hospital, Kano. Methods: A cross-sectional study was employed to select 280 eligible adolescents with SCD. They were assessed for depression and suicidality using the Patient Health Questionnaire (PHQ-9) and Suicide Behaviours Questionnaire (SBQ-R) and the data were analysed using IBM SPSS Version 24.0. Results: Over one-fifth (n=67; 23.9%) of the participants reported features suggestive of depression, even though a few of the participants (n=10; 3.6%) reported suicidality. Male gender (p=0.04) and frequency of hospitalization (p=0.01) were significantly associated with depression, while early adolescence (p=0.01), frequency of hospitalization (p=0.03), years lived with SCD (p=0.03), having no anaemic crises (p=0.04) and multiple use of analgesics (p=0.01), were found to be associated with suicidality. Similarly, frequent hospitalisation in the preceding year was an independent predictor of depression (aOR= 0.31, p=0.01, 95% CI=0.13-0.76). Conclusion: The magnitude of both depression and suicidality among adolescents with SCD is huge and appears to be grossly under reported. The use of validated simple screening tools such as PHQ-9 and SBQR should be incorporated into routine clinic follow up and healthcare providers should be trained in screening for depression and suicidality. Establishment of a multidisciplinary team including but not limited to haematologists, medical social workers and mental health specialists should be made a priority in all sickle cell clinics