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

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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.

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Acknowledgements

We would like to acknowledge the work and support provided by the staff of the Mental Health Project at the MRC/UVRI & LSHTM Uganda Research Unit. We would also like to acknowledge the support and corporation of children/adolescents, caregivers and management of The AIDS Support Organisation (TASO) clinic (Masaka), Kitovu Mobile AIDS organisation (Masaka), The Uganda Cares clinic (Masaka), Joint Clinical Research Centre clinic (Kampala) and Nsambya Home care Department (Kampala). This work was supported by a Medical Research Council / Department for International Development—African Leadership Award to Eugene Kinyanda, Number MR/L004623/1.

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Authors and Affiliations

  1. Mental Health Project, MRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, P.O. Box 49, Entebbe, Uganda

    Eugene Kinyanda & Richard S. Mpango

  2. Department of Psychiatry, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda

    Eugene Kinyanda, Noeline Nakasujja, Catherine Abbo & Seggane Musisi

  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

    Tatiana T. Salisbury & Ricardo Araya

  4. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Private Bag 3, Johannesburg, WITS 2050, South Africa

    Jonathan Levin

  5. Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa

    Soraya Seedat

  6. Department of Psychiatry, Stony Brook University, 01 Nicolls Rd, Stony Brook, New York, 11794, USA

    Kenneth D. Gadow

  7. Department of Global Health and Social Medicine, Harvard Medical School, A-111, 25 Shattuck St, Boston, MA, 02115, USA

    Vikram Patel

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  1. Eugene Kinyanda
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  2. Tatiana T. Salisbury
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  3. Jonathan Levin
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  4. Noeline Nakasujja
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Correspondence to Eugene Kinyanda.

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Kinyanda, E., Salisbury, T.T., Levin, J. et al. Rates, types and co-occurrence of emotional and behavioural disorders among perinatally HIV-infected youth in Uganda: the CHAKA study. Soc Psychiatry Psychiatr Epidemiol 54, 415–425 (2019). https://doi.org/10.1007/s00127-019-01675-0

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  • DOI: https://doi.org/10.1007/s00127-019-01675-0

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