Homozygous Beta thalassaemia is a lifelong condition requiring regular blood transfusions from infancy. The resulting iron overload damages the heart, liver and endocrines organs in particular, but can be treated with daily iron chelating agents, given either parentally or orally. However, adherence to treatment can be poor. In well treated patients life expectancy and quality of life have improved, and more emphasis is being placed on the psychological well-being of these patients. Depression is a common psychiatric complication in chronic disorders, even more so when the patient knows the condition is lifelong. Studies on adherence have been limited, but in a large cohort in North America, anxiety and depression were associated with difficulty in adherence. Low quality of life correlated with low income and poor compliance and comorbidities in an Iranian study.
Studies in the Arab countries have been relatively limited and mainly focused on the paediatric age group.
At Sultan Qaboos University Hospital over 200 patients with homozygous beta thalassemia are followed by both Hematology & Child Health Depts. Many are now at an age where they are thinking of the future as pertains to jobs, education and marriage. In addition, there is a cohort of adult patients who did not receive ideal treatment when younger due to a lack of resources. This group has increased prevalence of HCV positivity, splenectomy, thalassemic facies and hypogonadism, whereas the younger cohort have had access to better transfusion and oral chelators from a young age. This may result in increased depression and low self esteem in the older cohort.
