Rates and types of psychiatric disorders in perinatally human immunodeficiency virus-infected youth and seroreverters.
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.
Mellins
Claude Ann
CA
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York 10032, USA. cam14@columbia.edu
Brackis-Cott
Elizabeth
E
Leu
Cheng-Shiun
CS
Elkington
Katherine S
KS
Dolezal
Curtis
C
Wiznia
Andrew
A
McKay
Mary
M
Bamji
Mahrukh
M
Abrams
Elaine J
EJ
D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications; D002648:Child; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology; D019964:Mood Disorders / Q000150:complications; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000150:complications; D016896:Treatment Outcome