Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY 11794, USA.
J Dev Behav Pediatr. 2012 Jul;33(6):456-68. doi: 10.1097/DBP.0b013e31825b8482.
Cross-sectional research indicates high rates of mental health concerns among youth with perinatal HIV infection (PHIV), but few studies have examined emerging psychiatric symptoms over time.
Youth with PHIV and peer comparisons who were HIV-exposed but uninfected or living in households with HIV-infected family members (HIV-affected) and primary caregivers participated in a prospective, multisite, longitudinal cohort study. Groups were compared for differences in the incidence of emerging psychiatric symptoms during 2 years of follow-up and for differences in psychotropic drug therapy. Logistic regression models were used to evaluate the association of emerging symptoms with HIV status and psychosocial risk factors.
Of 573 youth with study entry assessments, 92% attended at least 1 annual follow-up visit (PHIV: 296; comparisons: 229). A substantial percentage of youth who did not meet symptom criteria for a psychiatric disorder at study entry did so during follow-up (PHIV = 36%; comparisons = 42%). In addition, those who met criteria at study entry often met criteria during follow-up (PHIV = 41%; comparisons = 43%). Asymptomatic youth with PHIV were significantly more likely to receive psychotropic medication during follow-up than comparisons. Youth with greater HIV disease severity (entry CD4% <25% vs 25% or more) had higher probability of depression symptoms (19% vs 8%, respectively).
Many youth in families affected by HIV are at risk for development of psychiatric symptoms.
横断面研究表明，围产期感染艾滋病毒（PHIV）的青少年心理健康问题发生率较高，但很少有研究探讨随着时间的推移而出现的新精神症状。
本研究纳入了 PHIV 青少年和具有对照意义的、感染 HIV 但未感染的青少年或与 HIV 感染者家庭成员（受 HIV 影响）和主要照顾者生活在一起的青少年，进行了一项前瞻性、多地点、纵向队列研究。在 2 年的随访期间，比较了各组新出现精神症状的发生率，并比较了精神药物治疗的差异。采用逻辑回归模型评估了新出现的症状与 HIV 状况和心理社会危险因素之间的关联。
在 573 名接受研究入组评估的青少年中，92%至少参加了 1 次年度随访（PHIV：296 例；对照组：229 例）。大量在研究入组时没有达到精神障碍症状标准的青少年在随访期间达到了标准（PHIV = 36%；对照组 = 42%）。此外，那些在入组时符合标准的青少年在随访期间往往也符合标准（PHIV = 41%；对照组 = 43%）。无症状的 PHIV 青少年在随访期间接受精神药物治疗的可能性显著高于对照组。HIV 疾病严重程度较高的青少年（入组时 CD4%<25%与 25%或以上）出现抑郁症状的可能性更高（分别为 19%和 8%）。
许多受 HIV 影响的家庭中的青少年都有出现精神症状的风险。
