Mental health functioning among children and adolescents with perinatal HIV infection and perinatal HIV exposure.
Mental health functioning among children and adolescents with perinatal HIV infection and perinatal HIV exposure.
复制标题
DOI：
10.1080/09540121.2011.575120
复制
发表时间：
2011-12
期刊：
影响因子：
1.7
通讯作者：
Pediatric HIV/AIDS Cohort Study Team
中科院分区：
文献类型：
--
作者：
Malee KM;Tassiopoulos K;Huo Y;Siberry G;Williams PL;Hazra R;Smith RA;Allison SM;Garvie PA;Kammerer B;Kapetanovic S;Nichols S;Van Dyke R;Seage GR 3rd;Mellins CA;Pediatric HIV/AIDS Cohort Study Team
在高活性抗逆转录病毒治疗（HAART）时代之前和期间，已经描述了围产期HIV感染儿童的心理健康问题（MHP）。然而，与MHP相关的儿童，照顾者和社会人口因素尚未完全了解。我们研究了围产期HIV暴露的大龄儿童和青少年中MHP的患病率，包括围产期HIV感染（PHIV+）和围产期HIV暴露但未感染（PHEU）的青年。我们的目的是通过比较PHIV+和PHEU青年来确定HIV感染的影响，并描述与MHP相关的风险因素，以便为制定适当的预防和干预策略提供信息。青少年和他们的照顾者接受了儿童行为评估系统第二版（BASC-2）的采访，以估计风险和临床显著MHP的比率，包括青少年报告的行为问题和青少年报告的情绪问题。在研究开始时，计算了该组总体的MHP患病率，以及HIV状态和人口统计学、儿童健康和护理人员特征。Logistic回归模型用于确定与青年MHP相关的因素。在2007年3月至2009年7月期间登记的416名青年中（295名PHIV+，121名PHEU），入学时MHP的总体患病率为29%，高于最近全国一般人口调查的预期。PHEU中MHP的发生率高于PHIV+儿童（38%对25%，p < 0.01）。在p < 0.10时，与MHP发生率较高相关的因素包括照顾者特征（精神障碍、限制设定问题、健康相关功能限制）和儿童特征（年龄较小和智商较低）。这些研究结果表明，PHEU儿童患MHP的风险很高，但目前对这些青少年的护理模式可能不支持早期诊断和治疗。针对受艾滋病毒影响的青少年及其照顾者的以家庭为基础的预防和干预计划可能会最大限度地减少MHP的长期后果。
Mental health problems (MHPs) among children with perinatal HIV infection have been described prior to and during the highly active antiretroviral therapy (HAART) era. Yet child, caregiver and socio-demographic factors associated with MHPs are not fully understood. We examined the prevalence of MHPs among older children and adolescents with perinatal HIV exposure, including both perinatally HIV-infected (PHIV+) and perinatally HIV-exposed but uninfected (PHEU) youth. Our aims were to identify the impact of HIV infection by comparing PHIV+ and PHEU youth and to delineate risk factors associated with MHPs, in order to inform development of appropriate prevention and intervention strategies. Youth and their caregivers were interviewed with the Behavior Assessment System for Children, 2nd edition (BASC-2) to estimate rates of at-risk and clinically significant MHPs, including caregiver-reported behavioral problems and youth-reported emotional problems. The prevalence of MHPs at the time of study entry was calculated for the group overall, as well as by HIV status and by demographic, child health, and caregiver characteristics. Logistic regression models were used to identify factors associated with youth MHPs. Among 416 youth enrolled between March 2007 and July 2009 (295 PHIV+, 121 PHEU), the overall prevalence of MHPs at entry was 29% and greater than expected based on recent national surveys of the general population. MHPs were more likely among PHEU than among PHIV+ children (38% versus 25%, p < 0.01). Factors associated with higher odds of MHPs at p < 0.10 included caregiver characteristics (psychiatric disorder, limit-setting problems, health-related functional limitations) and child characteristics (younger age and lower IQ). These findings suggest that PHEU children are at high risk for MHPs, yet current models of care for these youth may not support early diagnosis and treatment. Family-based prevention and intervention programs for HIV affected youth and their caregivers may minimize long-term consequences of MHPs.
登录
查看更多内容
了解早期生活压力经历对大脑和身体功能的影响。
DOI：
10.1016/j.metabol.2008.07.006
发表时间：
2008-10
期刊：
Metabolism: clinical and experimental
影响因子：
--
作者：
McEwen BS
通讯作者：
McEwen BS
影响因子：
6.4
作者：
GOODMAN, R
通讯作者：
GOODMAN, R
DOI：
10.1111/j.1469-7610.2007.01755.x
发表时间：
2007-08-01
影响因子：
7.6
作者：
Hysing, Mari;Elgen, Irene;Lundervold, Astri J.
通讯作者：
Lundervold, Astri J.
影响因子：
--
作者：
BROUWERS, P;DECARLI, C;PIZZO, P
通讯作者：
PIZZO, P
影响因子：
10.5
作者：
Emerson, Eric;Hatton, Chris
通讯作者：
Hatton, Chris