COMMON MENTAL DISORDER AND QUALITY OF LIFE OF PEOPLE WITH SICKLE CELL DISEASE IN THE STATE OF PARAÍBA
Racial health inequality. Social determinants of health. Chronic pain. Epidemiology. Mental health.
Sickle cell disease (SCD) is a serious chronic disease distributed throughout Brazil, with a wide variety of symptoms and clinical complications, especially pain. More common among the Black population, patients suffer from psychological complications and mental health problems that often go unrecognized and untreated. Little is known about the relationship between socioeconomic and demographic characteristics and the mental health and quality of life (QoL) of these individuals in the country. This study analyzed the prevalence of common mental disorders (CMD) and QoL in people with SCD in the state of Paraíba, investigating associated sociodemographic, clinical, and healthcare factors. This cross-sectional study included 119 adults with SCD living in 42 municipalities in Paraíba. Data were collected using three instruments: a sociodemographic and health questionnaire, the Self-Reporting Questionnaire (SRQ-20) for screening for CMDs, and the World Health Organization Quality of Life-bref (WHOQOL-Bref) for assessing QoL. Student's t-test, one-way ANOVA, Poisson regression, confirmatory factor analysis, Spearman's correlation, and linear regression were applied. The study population was predominantly Black, with low education and income, and presented high social vulnerability. There was a high prevalence of symptoms suggestive of CMD (57.6%; 95% CI: 48.7%–66.5%), associated with female gender, more frequent pain, and having experienced racism during healthcare. Furthermore, working and studying act as protective factors for this outcome. Quality of life was low, with the physical domain being the most affected, especially regarding pain and financial resources. Regression analysis demonstrated that the presence of CMD symptoms, pain frequency, family income, and the perception of healthcare professionals' training negatively impacted all domains of QoL. The experience of living with SCD in Paraíba is characterized by multiple social vulnerabilities and failures in the healthcare system, such as late diagnosis and unequal access to treatment across regions. This thesis contributes to broadening understanding of the relationship between psychological distress, QOL, and social determinants of health, providing support for more sensitive clinical practices and public policies that favor comprehensive care, with special attention to the structural dimensions that perpetuate inequalities.