(197) Association of Pain, Anxiety, Depression, and Fatigue with Sensitization in Outpatient Adults with Sickle Cell Disease

Adults with sickle cell disease (SCD) have episodic crisis pain and chronic pain. Little is known about SCD chronic pain phenotypes. Quantitative sensory testing (QST) identifies the objective contribution of allodynia and hyperalgesia to chronic SCD pain phenotypes. However, self-report measures are needed to further characterize SCD chronic pain phenotypes. Our aim was to determine associations among QST-determined sensitization and anxiety, depression, and fatigue among outpatients with SCD. In a cross-sectional study, subjects (N=186, mean age 36.6 ± 11.7 years [19-74 years], 97% African American, 59% female; SC type 72% SS, 18% SC, 5% S-β thal+, 4% unknown) completed thermal and mechanical QST [heat/cold/mechanical pain thresholds and levels]) at three body sites. They completed pain intensity (API [average of pain now, least, and worst pain in the past 24 hours]) on a scale of 0 [no pain] to 10 [pain as bad as it could be] and the PROMIS anxiety (α=.90), depression (α=.94), and fatigue (α=.83) scales (higher scores represent more of the concept being measured). Descriptive analysis, Independent t-tests, and multiple linear logistic regression were conducted. QST findings indicated that 58 (31%) patients had sensitization and 126 (68%) did not have sensitization (two had missing data). Bivariate analysis for sensitized vs not sensitized groups were API, 5.3 ± 2.2 vs. 4.0 ± 2.4 (p= 0.001); anxiety, 56.2 ± 8.5 vs 52.6 ± 9.1 (p= 0.01); depression, 55.1 ± 10.2 vs 51.0 ± 9.2 (p= 0.01); and fatigue, 59.8 ± 9.1 vs 54.9 ± 8.6 (p=.001). API, fatigue, depression, and anxiety were not significant in the logistic regression model including all four as predictors of sensitization. Focus of future studies should be on factors that are associated with sensitization in adults with SCD. Supported by grant #: R01 HL124945-01 (MPIs: Wilkie, Molokie, Wang).