Eugene Kinyanda1,2, Tatiana T Salisbury3, Jonathan Levin4, Noeline Nakasujja5, Richard S Mpango6, Catherine Abbo5, Soraya Seedat7, Ricardo Araya3, Seggane Musisi5, Kenneth D Gadow8, Vikram Patel9. 1. Mental Health Project, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, P.O. Box 49, Entebbe, Uganda. Eugene.Kinyanda@mrcuganda.org. 2. Department of Psychiatry, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda. Eugene.Kinyanda@mrcuganda.org. 3. Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, Camberwell, London, SE5 8AF, UK. 4. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Private Bag 3, Johannesburg, WITS 2050, South Africa. 5. Department of Psychiatry, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda. 6. Mental Health Project, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, P.O. Box 49, Entebbe, Uganda. 7. Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa. 8. Department of Psychiatry, Stony Brook University, 01 Nicolls Rd, Stony Brook, New York, 11794, USA. 9. Department of Global Health and Social Medicine, Harvard Medical School, A-111, 25 Shattuck St, Boston, MA, 02115, USA.
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.
PURPOSE: To describe the rates, types and comorbidity of emotional and behavioural disorders among perinatally HIV-infectedchildren 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.
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