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围生期 HIV 感染的波兰儿童和青少年的精神、行为和情绪障碍。

Psychiatric, behavioral and emotional disorders in Polish children and adolescents with perinatal HIV infection.

机构信息

Warszawski Uniwersytet Medyczny, Klinika Psychiatrii Wieku Rozwojowego.

SWPS Uniwersytet Humanistycznospołeczny, Wydział Psychologii.

出版信息

Psychiatr Pol. 2021 Dec 31;55(6):1387-1404. doi: 10.12740/PP/OnlineFirst/121980.

Abstract

OBJECTIVES

The aims of the study were to evaluate the prevalence of psychiatric, behavioral and emotional disorders in children and adolescents with perinatal HIV infection and to establish their possible relationships with clinical and sociodemographic variables.

METHODS

56 children with perinatal HIV infection (PHIV+ group), 24 healthy children perinatally HIV-exposed but uninfected (PHEU) and 43 healthy children of uninfected parents (HIV-nA), aged 6-18 years, were assessed. The Child Behavior Checklist (CBCL/4-18), completed by parents, and the Youth Self-Report (YSR) were used to assess behavioral and emotional disorders, while the semi-structured diagnostic interview K-SADS-PL was used to assess the symptoms of psychiatric disorders.

RESULTS

Higher prevalence of psychiatric disorders was found in the PHIV+ group and the PHEU group compared to the HIV-nAgroup. Anxiety disorders and affective disorders were diagnosed most often. Prevalence of symptoms of emotional and behavioral disorders in the PHIV+ group and in the PHEU group was associated with similar sociodemographic variables (male, not living with the biological caregiver, the experience of stressful life events). Psychiatric disorders were noted more often among PHIV+ subjects whose ARV treatment was started after 12 months of age. Positive correlations were observed between the results of some YSR and CBCL/4-18 problem scales and CD4 counts at the time of the study, higher logarithm of viral load at the start of ARV treatment and at the time of HIV diagnosis.

CONCLUSIONS

The prevalence of psychiatric disorders in PHIV+ group and the PHEU group is higher in comparison with HIV-nAgroup. Amore serious course of HIV infection and its severity before treatment are associated with the severity of internalizing problems.

摘要

目的

本研究旨在评估围生期 HIV 感染儿童和青少年的精神、行为和情绪障碍的患病率,并确定其与临床和社会人口学变量的可能关系。

方法

评估了 56 名围生期 HIV 感染儿童(PHIV+ 组)、24 名围生期 HIV 暴露但未感染的健康儿童(PHEU)和 43 名未感染父母的健康儿童(HIV-nA),年龄在 6-18 岁之间。使用儿童行为检查表(CBCL/4-18)和青少年自我报告(YSR)由父母完成,以评估行为和情绪障碍,而半结构化诊断访谈 K-SADS-PL 则用于评估精神障碍的症状。

结果

与 HIV-nA 组相比,PHIV+组和 PHEU 组的精神障碍患病率更高。诊断出最常见的焦虑障碍和情感障碍。PHIV+组和 PHEU 组情绪和行为障碍症状的患病率与相似的社会人口学变量(男性、不与亲生照顾者生活、经历压力生活事件)相关。在开始 ARV 治疗后 12 个月以上开始 ARV 治疗的 PHIV+ 患者中,更常见到精神障碍。在研究时,一些 YSR 和 CBCL/4-18 问题量表的结果与 CD4 计数之间存在正相关,与 ARV 治疗开始时和 HIV 诊断时的病毒载量对数呈正相关。

结论

与 HIV-nA 组相比,PHIV+组和 PHEU 组的精神障碍患病率更高。在治疗前 HIV 感染的严重程度及其严重程度与内化问题的严重程度相关。

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