Rates, types and co-occurrence of emotional and behavioural disorders among perinatally HIV-infected youth in Uganda: the CHAKA study

Soc Psychiatry Psychiatr Epidemiol. 2019 Apr;54(4):415-425. doi: 10.1007/s00127-019-01675-0. Epub 2019 Feb 20.

Abstract

Purpose: To describe the rates, types and comorbidity of emotional and behavioural disorders among perinatally HIV-infected children and adolescents attending care at five HIV youth clinics in Central and Southwestern Uganda.

Methods: 1339 CA-HIV attending care at HIV youth clinics in Uganda were interviewed using the DSM-5-based Child and Adolescent Symptom Inventory-5 (CASI-5; caregiver reported) and the Youth Inventory-4R (YI-4R; youth reported). Prevalence, risk factors and comorbidity for psychiatric disorders were estimated using logistic regression models.

Results: According to caregiver or youth report, the prevalence of 'any DSM-5 psychiatric disorder' was 17.4% (95% CI 15.4-19.5%), while that of 'any behavioural disorder' was 9.6% (95% CI 8.1-11.2%) and that of 'any emotional disorder' was 11.5% (95% CI 9.9-13.3%). The most prevalent behavioural disorder was attention deficit hyperactivity disorder (5.3%), while the most prevalent emotional disorder was separation anxiety disorder (4.6%). The statistically significant risk factors were: for behavioural disorders, sex (more among males than females) and age group (more among adolescents than among children); for emotional disorders, age group (more among adolescents than among children) and the caregiver's highest educational attainment (more among CA-HIV with caregivers with secondary education and higher, than among CA-HIV with caregivers with no formal education or only primary level education). About a quarter (24.5%) of CA-HIV with at least one emotional disorder and about a third (33.5%) of the CA-HIV with at least one behavioural disorder had a comorbid psychiatric disorder.

Conclusion: There was a considerable burden of psychiatric disorders among CA-HIV that spanned a broad spectrum and showed considerable comorbidity.

Keywords: Adolescents; Africa; Children; Emotional and behavioural problems; HIV; Psychiatric disorder.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / virology
  • Child
  • Child, Preschool
  • Comorbidity
  • Educational Status
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / psychology
  • HIV Infections / transmission
  • HIV*
  • Humans
  • Infectious Disease Transmission, Vertical / statistics & numerical data*
  • Logistic Models
  • Male
  • Mood Disorders / epidemiology*
  • Mood Disorders / virology
  • Neurodevelopmental Disorders / epidemiology*
  • Neurodevelopmental Disorders / virology
  • Prevalence
  • Risk Factors
  • Uganda / epidemiology