Depression, suicidal ideation, and attempts in black patients with sickle cell disease.

There is a strong relationship between suicidal ideation, suicide attempts, and depression. Rates of successful suicides are relatively high among the chronically ill compared to other populations but are reduced with treatment. Depression and suicide rates also often differ among blacks as compared to other populations. Using survey methods, we evaluated self-reported rates of depression, suicidal ideation, and suicide attempts in 30 male and 37 female black patients with sickle cell disease (SCD). SCD is a condition characterized by chronic, unpredictable pains and psychosocial distress. Thirty-six percent of the sample self-reported depression in the past 30 days, while 22 percent of the sample exhibited scores on the Beck Depression Inventory indicative of mild or greater depression (mean BDI, 8.31 +/- 7.79). Twenty-nine percent of patients indicated an episode of suicidal ideation and 8%, a suicidal attempt in their lifetime. Thirty-three percent reported treatment by a mental health professional. We conclude that there is a continuing need for mental health services in the management of depressed affect and risk for suicide among patients with SCD. Standards of clinical care must remain flexible to accommodate the mental health needs of this population of patients.

The assessment of pain and discomfort in individuals with mental retardation.

This research was conducted to replicate and expanded the work of Bodfish et al. [Bodfish, J. W., Harper, V. N., Deacon, J. R., & Symons, F. J. (2001, May). Identifying and measuring pain in persons with developmental disabilities: A manual for the Pain and Discomfort Scale (PADS). Western Carolina Center Research Reports] by assessing the functional sensitivity of the Pain and Discomfort Scale (PADS) in patients with MR. We used the PADS to detect pain and discomfort during a dental scaling and polishing procedure. Subjects (N=28) with cognitive and communication deficits were assessed at multiple baselines, during and after the procedure. The results indicated that scores on the PADS were significantly higher during the scaling procedure than during all other observations quantified by the PADS. We conclude that the PADS is a functionally sensitive measure that may lack specificity, but that may also represent the state of the psychometric art of assessing pain in patients who have MR.

Perceived racial/ethnic harassment and tobacco use among African American young adults.

We examined the association between perceived racial/ethnic harassment and tobacco use in 2129 African American college students in North Carolina. Age-adjusted and multivariate analyses evaluated the effect of harassment on daily and less-than-daily tobacco use. Harassed participants were twice as likely to use tobacco daily (odds ratio = 2.01; 95% confidence interval=1.94, 2.08) compared with those with no reported harassment experiences. Experiences of racial/ethnic harassment may contribute to tobacco use behaviors among some African American young adults.