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Psychiatric morbidity in school-age children with congenital human immunodeficiency virus infection: a pilot study
J F Havens1, A H Whitaker, J F Feldman
1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.
Insights
Children with human immunodeficiency virus (HIV) infection showed high rates of behavioral issues, similar to those not infected. HIV-infected children may experience greater subjective distress, warranting further research into prenatal drug exposure effects.
Area of Science:
- Pediatrics
- Psychiatry
- Infectious Diseases
Background:
- Prenatal drug exposure and human immunodeficiency virus (HIV) infection are significant factors impacting child development.
- Understanding psychiatric morbidity in children with HIV is crucial, especially when co-occurring with prenatal substance exposure.
- Previous research has not fully elucidated the behavioral and emotional outcomes in school-aged children with HIV in foster care.
Purpose of the Study:
- To examine the relationship between HIV infection and psychiatric morbidity in children with a history of prenatal drug exposure.
- To compare behavioral and psychiatric outcomes among HIV-infected, seroreverted, and non-HIV-exposed children.
- To investigate levels of subjective distress in HIV-infected children compared to control groups.
Main Methods:
- A psychiatric diagnostic evaluation was conducted on 26 HIV-infected, 14 seroreverted, and 20 control children.
- Data collection included structured diagnostic interviews with caretakers, behavior checklists, and child self-reports using pictorial interviews.
- Age, ethnicity, and IQ were controlled for in the analyses to account for group differences.
Main Results:
- High rates of behavioral and psychiatric morbidity, particularly disruptive behavior disorders, were observed in all groups.
- HIV-infected children did not exhibit significantly higher rates of overall psychiatric morbidity compared to seroreverted or non-HIV-exposed children.
- There was an indication that HIV-infected children experienced higher levels of subjective distress.
Conclusions:
- While HIV infection itself was not associated with higher overall psychiatric morbidity in this cohort, prenatal drug exposure may significantly contribute to behavioral issues.
- HIV-infected children may be more susceptible to subjective distress, necessitating age-appropriate assessment methods.
- Further research is needed to explore the long-term impact of prenatal drug exposure and HIV on child psychiatric health and well-being.
Abstract:
This study examined the relationship between human immunodeficiency virus (HIV) infection and psychiatric morbidity within the context of prenatal drug exposure. Twenty-six HIV-infected, 14 seroreverted, and 20 control (non-HIV-exposed) children were studied; the sample consisted of nonreferred children living in foster placement who had been exposed to maternal drug addiction. Each child received a psychiatric diagnostic evaluation which included completion by the caretaker of a structured diagnostic interview and a behavior checklist on the child as well as a child self-report on a pictorial interview. Age, ethnicity, and IQ were controlled in the analyses because of group differences. There were high rates of behavioral and psychiatric morbidity, especially with respect to disruptive behavior disorders, in this sample of school-age children with HIV infection, but similarly high rates were found in the seroreverted and non-HIV-exposed children. There was some suggestion that the HIV-infected children were experiencing higher levels of subjective distress than either the nonexposed or seroreverted children. The possible relevance of drug exposure to the behavioral outcomes observed here is discussed, as well as the importance of using age-appropriate materials to elicit subjective distress in HIV-infected school-age children. Clinical implications and directions for further research are discussed.