Rates and types of psychiatric disorders in perinatally human immunodeficiency virus‐infected youth and seroreverters

Abstract

Background The purpose of this study was to examine 1) the prevalence of psychiatric and substance use disorders in perinatally HIV-infected (HIV+) adolescents and 2) the association between HIV infection and these mental health outcomes by comparing HIV+ youths to HIV exposed but uninfected youths (HIV-) from similar communities. Methods Data for this paper come from the baseline interview of a longitudinal study of mental health outcomes in 9-16 year old perinatally HIV-exposed youths (61% HIV+) and their caregivers. Three hundred forty youths and their primary adult caregivers were recruited from four medical centers and participated in separate individual interviews. Youth psychiatric disorder was assessed using the caregiver and youth versions of The Diagnostic Interview Schedule for Children (DISC-IV). Results According to caregiver or youth report, a high percentage of HIV+ and HIV- youths met criteria for a non-substance use psychiatric disorder, with significantly higher rates among the HIV+ youths (61% vs 49%, OR=1.59; CI=1.03,2.47; p < .05). The most prevalent diagnoses in both groups were anxiety disorders (46% for total sample) which included social phobia, separation anxiety, agoraphobia, generalized anxiety disorder, panic disorder, obsessive- compulsive disorder, and specific phobias. One quarter of the sample met criteria for a behavioral disorder (ADHD, conduct disorders, and oppositional defiant disorders), with ADHD being most prevalent. HIV+ youths had significantly higher rates of ADHD (OR=2.45; CI=1.20, 4.99, p < .05). Only 7% of youths met criteria for a mood disorder and 4% for a substance abuse disorder. Several caregiver variables (caregiver type and HIV status) were also associated with both child HIV status and mental health outcomes. Conclusions Our data suggest that HIV+ youths are at high risk for mental health disorders. Further longitudinal research is necessary to understand the etiology, as well as potential protective factors, in order to inform efficacy-based interventions.

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

“…It is increasingly acknowledged that HIV‐infected young people have relatively high rates of mental health disorder 98, 222, 223. Whether these are higher than in other patient groups with chronic medical conditions, HIV‐exposed but uninfected siblings or well‐matched healthy controls is yet to be fully determined 222, 224, 225, 226.…”

“…Whether these are higher than in other patient groups with chronic medical conditions, HIV‐exposed but uninfected siblings or well‐matched healthy controls is yet to be fully determined 222, 224, 225, 226. Nevertheless, it is essential that the multidisciplinary team at least monitor for symptoms and signs of psychological distress and mental health disorder, as children progress into adolescence and young adult life.…”

Mujeres jóvenes con infección por VIH adquirida por transmisión vertical: Expectativas de tener hijos no infectados

“…En el aspecto psico-social, las diferentes series muestran alta prevalencia de abuso de sustancias, alteraciones mentales, desarrollo neurocognitivo muy inferior a la población normal de la misma edad, manifestaciones neuro-psiquiátricas tales como depresión, estados de ansiedad, impulsividad, con una frecuencia de hasta 60%, lo que puede provocar problemas serios, no sólo en el embarazo, sino también en el post parto, con tremendas repercusiones para el RN [12][13][14][15] . Se ha demostrado que el desarrollo neurocognitivo y las alteraciones mentales influyen directamente en la adherencia de estas pacientes a la TARV [16][17][18][19] .…”

Brief Report: Language Ability and School Functioning of Youth Perinatally Infected With HIV

“…In a pilot study for a larger, longitudinal project examining a range of psychosocial and behavioral functioning variables (Mellins, Brackis-Cott, Dolezal, & Abrams, 2006), 43 early adolescents perinatally infected with HIV/AIDS and their primary caregivers were recruited in 2004 from a comprehensive pediatric HIV care and research program in NYC. Inclusion criteria for youth were 1) perinatal infection with HIV, 2) ages 9-16 years, 3) English speaking, and 4) having a legal guardian who could provide informed consent.…”