DSM-IV mental disorders and neurological complications in children and adolescents with human immunodeficiency virus type 1 infection (HIV-1).
OBJECTIVE
- To study the types of psychiatric problem encountered in children infected with the human immunodeficiency virus (HIV) and their relationship to central nervous system disorder and the severity of infection.


METHODS
- 17 HIV-infected children presenting with psychiatric problems were included. Mental disorders were evaluated according to DSM-IV criteria. Neurological disorders and progressive encephalopathy (presence or absence) diagnosis were evaluated by clinical and radiological examination. The severity of infection was assessed by the percentage of CD4 lymphocytes.


RESULTS
- The most frequent diagnoses were major depression (MDD: 47%) and attention deficit hyperactivity disorder (ADHD: 29%). Major depression diagnosis was significantly associated with neuroimaging or clinical neurological abnormalities (p < 0.01). In contrast, no association was found between hyperactivity diagnosed according to DSM-IV criteria and central nervous system disorder. Percentage of CD4 lymphocytes were close to 0 for more than 80% of children presenting with psychiatric complications.


CONCLUSIONS
- The very low % of CD4 lymphocytes of these children suggest that the appearance of a psychiatric complication should be regarded as a factor indicating severe HIV infection. Depressive disorders may be a clinical form of encephalopathy.
Misdrahi
D
D
Child and Adolescent Psychiatry Department, Necker Enfants Malades Hospital, 149, rue de Sèvres, 75015 Paris, France.
Vila
G
G
Funk-Brentano
I
I
Tardieu
M
M
Blanche
S
S
Mouren-Simeoni
M C
MC
D015526:AIDS Dementia Complex / Q000453:epidemiology*; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D015704:CD4 Antigens / Q000276:immunology; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*
D015704:CD4 Antigens