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Maryland Pao, MD; Maureen Lyon, PhD; Lawrence J. D'Angelo, MD; Wendy B. Schuman, PhD; Tisha Tipnis, BA; David A. Mrazek, MD

Arch Pediatr Adolesc Med. 2000;154:240-244.

Objective  To provide a descriptive analysis of the prevalence of past and current psychiatric disorders in adolescents positive for the human immunodeficiency virus (HIV).

Design  Structured interview in a convenience sample in a primary care urban adolescent clinic in Washington, DC.

Participants  Thirty-four HIV-seropositive adolescents ranging in age from 16 to 21 years.

Main Outcome Measures  The Structured Clinical Interview for DSM-IV Axis I Disorders–Patient Edition (SCID-P) was administered by a child psychiatrist or a clinical child psychologist. Extensive review of medical records was also conducted.

Results  A majority of the HIV-infected adolescents in our sample had received psychiatric diagnoses prior to their treatment at the clinic (53%), had a documented history of sexual abuse (50%), and had a history of substance use (82%). Psychiatric diagnoses determined by the SCID-P indicated that 85% of the sample had a current Axis I disorder, with 44% reporting ongoing depressive disorders.

Conclusions  The majority of subjects in this sample had had a previous psychiatric diagnosis, and almost half had a current affective disorder. Psychiatric disorders, especially affective disorders, may be a risk factor for high-risk sexual behaviors and substance use that increases the risk for HIV infection in adolescent populations.

From the Departments of Psychiatry and Behavioral Sciences and Adolescent and Young Adult Medicine, Children's National Medical Center, Washington, DC.

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