Emotional and behavioural disorders in HIV seropositive adolescents in urban uganda

Objective: To investigate the emotional and behavioral problems of HIV sero-positive adolescents. Design: A cross-sectional descriptive study. Setting: A specialised HIV/ AIDS Health Care Centre, the Mildmay Centre, in Kampala, Uganda. Subjects: Eighty two HIV sero-positive adolescents were consecutively enrolled for the study. Results: Over half (55.6%) of the subjects were females. They were mostly (88.9%) under the age of 15 years, orphans (97.6%) and stayed with non-parental relatives (68.3%). Almost two thirds (60.9%) of them were in the HIV/ AIDS clinical disease stage III or IV and were not on ARVs drugs. Forty two (51.2%) of the subjects had significant psychological distress (SRQ-25 scores ≥ 6) and 14 (17.1 %) had attempted suicide within the last 12 months. Their specific psychiatric disorders, made using ICD-10 criteria, were: Anxiety 45.6%, depression 40.8%, somatisation 18.0%, seizures 8.4%, mania 1.2% and HIV-associated progressive encephalopathy 4.8%. Conclusion: HIV/AIDS infection in adolescence was associated with considerable psychological problems and the presence of major psychiatric disorders. With the current increasing availability of effective antiretroviral therapy, many of these children are surviving into adolescence, thus calling for the development of adolescent friendly HIV medical and psychological support and treatment services in developing countries such as Uganda.