Psychiatric Morbidity in School-Age Children with Congenital Human Immunodeficiency Virus Infection

This study examined the relationship between human immunodeficiency virus (HIV) infection and psychiatric morbidity within the context of prenatal drug exposure. Twenty-six HIV-infected, 14 seroreverted, and 20 control (non-HIV-exposed) children were studied; the sample consisted of nonreferred children living in foster placement who had been exposed to maternal drug addiction. Each child received a psychiatric diagnostic evaluation which included completion by the caretaker of a structured diagnostic interview and a behavior checklist on the child as well as a child self-report on a pictorial interview. Age, ethnicity, and IQ were controlled in the analyses because of group differences. There were high rates of behavioral and psychiatric morbidity, especially with respect to disruptive behavior disorders, in this sample of school-age children with HIV infection, but similarly high rates were found in the seroreverted and non-HIV-exposed children. There was some suggestion that the HIV-infected children were experiencing higher levels of subjective distress than either the nonexposed or seroreverted children. The possible relevance of drug exposure to the behavioral outcomes observed here is discussed, as well as the importance of using age-appropriate materials to elicit subjective distress in HIV-infected school-age children. Clinical implications and directions for further research are discussed.