Longitudinal Study of Emerging Mental Health Concerns in Youth Perinatally Infected With HIV and Peer Comparisons

Abstract

Objective Cross-sectional research indicates high rates of mental health concerns among youth with perinatal HIV infection (PHIV), but few studies have examined emerging psychiatric symptoms over time. Methods Youth with PHIV and peer comparisons who were HIV-exposed but uninfected or living in house-holds with HIV-infected family members (HIV-affected) and primary caregivers participated in a prospective, multisite, longitudinal cohort study. Groups were compared for differences in the incidence of emerging psychiatric symptoms during 2 years of follow-up and for differences in psychotropic drug therapy. Logistic regression models were used to evaluate the association of emerging symptoms with HIV status and psychosocial risk factors. Results Of 573 youth with study entry assessments, 92% attended at least 1 annual follow-up visit (PHIV: 296; comparisons: 229). A substantial percentage of youth who did not meet symptom criteria for a psychiatric disorder at study entry did so during follow-up (PHIV = 36%; comparisons = 42%). In addition, those who met criteria at study entry often met criteria during follow-up (PHIV = 41%; comparisons = 43%). Asymptomatic youth with PHIV were significantly more likely to receive psychotropic medication during follow-up than comparisons. Youth with greater HIV disease severity (entry CD4% <25% vs 25% or more) had higher probability of depression symptoms (19% vs 8%, respectively). Conclusions Many youth in families affected by HIV are at risk for development of psychiatric symptoms.

Growing up HIV-positive in Uganda: “psychological immunodeficiency”? A qualitative study

“…attention deficit hyperactivity disorder), and emotional disorders (e.g. anxiety and depressive disorders) [3][4][5][6][7][8] Psychiatric disorders among children and adolescents with HIV leads to psychological distress and impaired quality of life, increased stigma and isolation and may lead to negative clinical and behavioral outcomes. Despite antiretroviral therapy improving the survival of HIV-infected children, the mental health problems of these children and adolescents have had less attention [9].…”

Psychosocial issues among children and adolescents in an integrated paediatric HIV psychology service in Botswana

“…There has been a call for better psychosocial care of HIV-positive patients (Eaton, McCay, Semrau, Chatterjee, Baingana, Araya, … Saxena, 2011) to address their unique psychosocial issues (Gadow, Angelidou, Chernoff, Williams, Heston, Hodge, & Nachman, 2012;Steele, Nelson, & Cole, 2007). Gadow et al (2012) reported higher than expected rates of psychological problems in HIV-infected children.…”

Perinatally infected adolescents living with human immunodeficiency virus (perinatally human immunodeficiency virus)

“…The results showed that the performance of the PHIV youths was poorer compared to the control group, which consisted of agematched HIV-uninfected volunteers [44] . In regard to mental health, the incidence of psychiatric disorders is higher among PHIV adolescents and uninfected youths belonging to HIV-infected families compared to the general population [45][46][47] . Several studies found that up to 70% of such adolescents meet psychiatric diagnostic criteria.…”

“…Several studies found that up to 70% of such adolescents meet psychiatric diagnostic criteria. Some authors found correlations between diagnosis in adolescents and psychiatric disorders among their caretakers [45][46][47] .…”