We interviewed 170 sickle cell disease (SCD) patients (mean age 25 years) with a modified version of the Frankfurter Befindlichkeitskala (FBS, 33-item) and the 12-item General Health Questionnaire (GHQ-12), with a view to highlighting the psychosocial issues which worry them, the way they cope with these problems, and the factors associated with these issues. The mean FBS score of SCD patients was comparable with those of insulin dependent diabetics, but significantly higher than that of non-insulin dependent diabetics. The FBS scores were significantly correlated with GHQ-12 scores. Feelings of inadequacy of social contact were significantly associated with high FBS and GHQ scores. Some common complaints were: the limitations illness placed on social life; depressive feelings; abnormal habitus; suicidal ideation during crises; and the burden of illness on the family. They frequently resorted to prayers as a method of coping, as most had no clear ideas on how to deal with these issues. Worries over psychosocial consequences of SCD, seem to add considerably to the burden of illness, and clinicians will offer better care to patients if they routinely enquire into some of these issues and offer health education and counselling in a group setting.