Abstract

Sickle cell anemia (SCA) is a blood disorder characterized by abnormal hemoglobin, leading to changes in red blood cell shape and vaso-occlusive crises. Cerebral infarcts associated with neurological complications have been observed in individuals with SCA, with potential links to psychosis. This case report details a 29-year-old male with SCA presenting with psychosis, exploring the interplay between silent cerebral infarcts and neuropsychiatric symptoms. The patient's clinical course, including paranoia, aggression, and psychosis, is described following the progression of the patient’s SCA and painful sickle-cell crises due to medication non-adherence. Neurological complications in SCA, specifically silent cerebral infarcts, are highlighted as potential contributors to cognitive decline and psychosis. While depression and anxiety are prevalent in SCA, psychosis is less frequently reported. The study emphasizes the need for further research on the relationship between SCA, cerebral infarcts, and psychosis to improve understanding and management.

Additionally, challenges in pain management for SCA patients, including disparities in healthcare access and psychiatric comorbidities, are discussed. The impact of psychosis on SCA outcomes, frequency of pain crises, and healthcare utilization is underscored. The exclusion of patients with severe mental illnesses from pain management trials raises questions about the applicability of current regimens. Future research should explore the relationship between SCA and various psychiatric illnesses to enhance outpatient pain management strategies and overall medical outcomes for this population.