Premium
Neurocognitive and psychological effects of persistent pain in pediatric sickle cell disease
Author(s) -
Connolly Megan E.,
Bills Sarah E.,
Hardy Steven J.
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27823
Subject(s) - medicine , neurocognitive , quality of life (healthcare) , disease , wechsler adult intelligence scale , wechsler intelligence scale for children , pain catastrophizing , neuropsychology , physical therapy , clinical psychology , psychiatry , pediatrics , cognition , chronic pain , nursing
Background Pain is a major complication of sickle cell disease (SCD), spanning vaso‐occlusive crises and persistent pain. Although it is known that persistent pain is associated with considerable impairment in youth without SCD, little is known about the functional effects of persistent pain in SCD. The current study aimed to (a) characterize persistent pain in youth with SCD and (b) determine the extent to which youth with SCD and persistent pain differ in disease morbidity, functional impairment, and neurocognitive and psychological functioning. Procedure Eighty‐nine participants (ages 7‐16) and caregivers completed questionnaires (BRIEF [Behavior Rating Inventory of Executive Function], Conners‐3 [Conners—third edition], and PedsQL™‐SCD Module, where PedsQL is Pediatric Quality of Life Inventory). Participants completed neurocognitive tests WISC‐V [Wechsler Intelligence Scale for Children‐fifth edition], WJ‐III [Woodcock Johnson Tests of Achievement—third edition], and WIAT‐III [Wechsler Individual Achievement Test—third edition]). Youth were classified as having persistent pain if they reported daily pain for 7 days. Chi‐square and independent sample t ‐test analyses were used to assess group differences (those with vs without persistent pain). Results Patients with persistent pain ( n = 18) reported lower health‐related quality of life ( P = .000). Caregivers were more likely to rate youth with persistent pain as having lower planning/organization abilities ( P = .011) and clinically elevated symptoms of defiance/aggression and oppositional defiance ( P s = .00; .01). Patients with persistent pain demonstrated poorer working memory ( P = .023) and processing speed ( P = .027), and fewer demonstrating reading fluency abilities in the average or above range ( P = .026). Conclusions Youth with SCD and persistent pain are at risk for psychosocial and neurocognitive impairments, suggesting that persistent pain may be an important indicator of disease burden. Furthermore, disease management may be enhanced by assessing cognitive and psychosocial functioning and incorporating interdisciplinary treatments addressing impairment associated with persistent pain.