mental health AIDS

Summer 2006 Newsletter / Volume 7, Issue 4

HIV Assessment News

Psychiatric Assessment

Mellins, Brackis-Cott, Dolezal, and Abrams (2006) conducted a pilot study to explore rates and types of DSM-diagnosable psychiatric and substance use disorders, as well as emotional and behavioral functioning, in a sample of 47 perinatally HIV-infected children and adolescents between the ages of 9 and 16 years receiving services in an HIV clinic in New York City. The youths and their primary caregivers "were interviewed using standardized assessments of youth psychiatric disorders and emotional and behavioral functioning, as well as measures of health and caregiver mental health" (p. 432). According to the caregivers and/or the youths in their care,

55% (26 of 47) of the youth met criteria for a psychiatric disorder and 26% (n = 12) of the children met criteria for multiple disorders. The most prevalent diagnoses were anxiety disorders (40%; n = 19), which included social phobia [4%], separation anxiety [8%], agoraphobia [8%], panic disorder [2%], obsessive-compulsive disorder [8%] and specific phobias (eg, insects, snakes, dogs, dark, shots, elevators[; 21%]). Behavioral disorders were also prevalent (23%; n = 11), including attention deficit hyperactivity disorders [21%], conduct disorders [13%] and oppositional defiant disorders [11%]. Four children [8%] met criteria for a mood disorder and one child [2%] met criteria for a substance abuse (marijuana) disorder. (p. 434)

Importantly, "the majority of caregivers and children scored in the normative range on the symptom questionnaires on emotional and behavioral functioning. None of the demographic or child health variables or measures of caregiver mental health was significantly associated with presence of a child psychiatric disorder. There was[, however,] an association between caregiver mental health and child emotional and behavioral functioning" (p. 432). Mellins and colleagues conclude that "[h]igh rates of disorders that typically warrant … intervention were reported by caregivers and children in this pilot study ... [and] efficacy-based psychopharmacologic and psychologic treatment programs (particularly cognitive behavioral interventions) exist to treat the majority of disorders found in this population. ... [I]ncorporating mental health interventions into the … care of HIV-infected adolescents is critical for the health and well-being of this population" (p. 436).

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