Psychiatric Considerations in Children and Adolescents with HIV/AIDS

Benton, Tami D.

doi:10.1016/j.pcl.2011.06.013

Cited by 9 publications

(4 citation statements)

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“…Specifically, we examined the association between changes in MHS and youths’ sociodemographic characteristics, their context, and their self-regulation. Consistent with prior research, we hypothesized that PHIV+ youths would have higher rates of increase in MHS compared to PHEU youths (1); changes in youths’ MHS across adolescence would be positively associated with greater exposure to negative contextual factors (e.g., greater environmental stress, caregiver distress, and household poverty (6–8, 10) and negatively associated with self-regulation factors (e.g., future orientation) (19, 20). …”

Section: Introductionmentioning

confidence: 67%

“…bereavement, family conflict and dissolution), caregiver HIV status, and poor caregiver mental or physical health (6–8). Neighborhood factors such as poverty, violence, victimization and racism, common among inner city neighborhoods in which HIV infection has been concentrated in the United States (US) (9), have also been associated with youth MHPs (6, 10).…”

Section: Introductionmentioning

confidence: 99%

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A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV-Infected and HIV-Exposed but Uninfected Urban Youths

Mutumba

Bauermeister

Elkington

et al. 2016

Journal of Adolescent Health

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Purpose Significant gaps persist in our understanding of the etiological factors that shape the progression of mental health symptoms (MHS) among perinatally HIV-infected (PHIV+) and perinatally HIV-exposed but uninfected (PHEU) youths. This study sought to assess the changes in MHS among PHIV+ and PHEU youths as they transition through adolescence, and to identify the associated psychosocial factors. Methods Data were drawn from a longitudinal study of 166 PHIV+ and 114 PHEU youths (49% male, ages 9 – 16 at baseline) in New York City. Individual interviews were administered at baseline and subsequently over a 5 year period. MHS were assessed using the youth version of the Diagnostic Interview Schedule for Children (DISC-IV). Predictive growth curve analyses were conducted to assess longitudinal changes in MHS and identify the relevant factors. Level I predictors included: time, major life events, household poverty, caregiver mental health, and neighborhood stressors. Level II predictors included youths’ sociodemographic characteristics (e.g. age, gender, HIV status) and baseline future orientation scores. Results The changes in youths’ MHS followed a quadratic growth curve, and were positively associated with the number of major negative life events, and neighborhood stressors experienced. Youths’ HIV status, household poverty and caregiver mental health were not significantly associated with youths’ MHS. Conclusion Findings suggest that irrespective of youths’ HIV status, major life events and neighborhood stressors increase MHS among PHIV+ and PHEU youths. There is a need for interventions to reduce the impact of stressors on the mental wellbeing of PHIV+ and PHEU youths.

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Section: Introductionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV-Infected and HIV-Exposed but Uninfected Urban Youths

Mutumba

Bauermeister

Elkington

et al. 2016

Journal of Adolescent Health

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“…A review of eight studies on the prevalence of psychiatric disorders amongst HIV-infected children and youth (aged 4 to 21 years) using the Diagnostic and Statistical Manual (Fourth Edition; DSM-IV) found high rates of attention deficit/hyperactivity disorders (29%), anxiety (24%) and depression (25%); however, the authors noted the lack of control groups and small sample sizes as significant limitations [ 265 ]. Several reviews have similarly pointed to the methodological weaknesses in existing studies on psychosocial outcomes amongst PHIV+ and the complex interactions of genetic, social and environmental factors [ 266 , 267 ]. Indeed, in larger, more well-designed trials with appropriate control groups, studies reported less evidence for increased mental and behavioural disorders amongst PHIV+ in childhood or adolescence [ 263 , 268 – 270 ].…”

Section: Resultsmentioning

confidence: 99%

The physical and psychological effects of HIV infection and its treatment on perinatally HIV‐infected children

Vreeman

Scanlon

McHenry

et al. 2015

Journal of the International AIDS Society

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IntroductionAs highly active antiretroviral therapy (HAART) transforms human immunodeficiency virus (HIV) into a manageable chronic disease, new challenges are emerging in treating children born with HIV, including a number of risks to their physical and psychological health due to HIV infection and its lifelong treatment.MethodsWe conducted a literature review to evaluate the evidence on the physical and psychological effects of perinatal HIV (PHIV+) infection and its treatment in the era of HAART, including major chronic comorbidities.Results and discussionPerinatally infected children face concerning levels of treatment failure and drug resistance, which may hamper their long-term treatment and result in more significant comorbidities. Physical complications from PHIV+ infection and treatment potentially affect all major organ systems. Although treatment with antiretroviral (ARV) therapy has reduced incidence of severe neurocognitive diseases like HIV encephalopathy, perinatally infected children may experience less severe neurocognitive complications related to HIV disease and ARV neurotoxicity. Major metabolic complications include dyslipidaemia and insulin resistance, complications that are associated with both HIV infection and several ARV agents and may significantly affect cardiovascular disease risk with age. Bone abnormalities, particularly amongst children treated with tenofovir, are a concern for perinatally infected children who may be at higher risk for bone fractures and osteoporosis. In many studies, rates of anaemia are significantly higher for HIV-infected children. Renal failure is a significant complication and cause of death amongst perinatally infected children, while new data on sexual and reproductive health suggest that sexually transmitted infections and birth complications may be additional concerns for perinatally infected children in adolescence. Finally, perinatally infected children may face psychological challenges, including higher rates of mental health and behavioural disorders. Existing studies have significant methodological limitations, including small sample sizes, inappropriate control groups and heterogeneous definitions, to name a few.ConclusionsSuccess in treating perinatally HIV-infected children and better understanding of the physical and psychological implications of lifelong HIV infection require that we address a new set of challenges for children. A better understanding of these challenges will guide care providers, researchers and policymakers towards more effective HIV care management for perinatally infected children and their transition to adulthood.

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“…The increased prevalence of psychosis could be due to perinatally acquired HIV infection and subsequent central nervous system involvement, lifetime exposure to the virus, and immune dysfunction during brain development among various other possible causes. In addition, treatment with anti-retroviral treatment like efavirenz alone or in combination with psychotropic medications may also precipitate psychosis [21].…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Comorbidities in Pediatric Inpatients With Human Immunodeficiency Virus Infection and Impact on Hospital Course: Inputs From a Case-Control Inpatient Study

Dias¹,

Ayala²,

Aliduux³

et al. 2021

Cureus

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In this study, we aimed to delineate psychiatric comorbidities in pediatric inpatients with versus without human immunodeficiency virus (HIV) infection and to measure its impact on the length of stay (LOS) and cost of treatment during hospitalization. MethodologyWe conducted a case-control study using the Nationwide Inpatient Sample and included 4,920 pediatric inpatients between the ages of six and 18 years who were sub-grouped by a comorbid diagnosis of HIV (N = 2,595) and non-HIV (N = 2,325) and matched for demographics (age, sex, and race) by propensity casecontrol matching. Logistic regression analyses were used to evaluate the adjusted odds ratio (aOR) of association for psychiatric comorbidities (depression, anxiety, post-traumatic stress disorder, psychosis, and drug abuse) in the HIV-positive compared with the HIV-negative (as reference category) pediatric inpatients. We measured the differences in the LOS and cost using the independent sample t-test. ResultsWe found that the most prevalent psychiatric comorbidities in the HIV-positive group were anxiety (6.9%), drug abuse (6.6%), psychosis (6.4%), and depression (6.2%). The HIV-positive group had a significantly higher likelihood of comorbid psychosis (aOR: 1.82; 95% confidence interval [CI]: 1.38-2.40) and depression (aOR: 1.79; 95% CI: 1.36-2.36). The mean LOS per hospitalization episode was longer for the HIV-positive group (11.1 days vs. 6.0 days; P < 0.001) compared to the HIV-negative pediatric inpatients. ConclusionsWe found an increased risk of depression by 79% and psychosis by 82% in the HIV-positive pediatric population. These inpatients also had an extended hospitalization stay (by five days), adding to the healthcare economic burden.

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Psychiatric Considerations in Children and Adolescents with HIV/AIDS

Cited by 9 publications

References 45 publications

A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV-Infected and HIV-Exposed but Uninfected Urban Youths

A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV-Infected and HIV-Exposed but Uninfected Urban Youths

The physical and psychological effects of HIV infection and its treatment on perinatally HIV‐infected children

Psychiatric Comorbidities in Pediatric Inpatients With Human Immunodeficiency Virus Infection and Impact on Hospital Course: Inputs From a Case-Control Inpatient Study

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