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Uninfected children of HIV-infected mothers should be screened and followed up long-term for psychiatric problems, pediatricians from New York recommend, based on their experience.
Over 2 years, Dr. Laurie J. Bauman from Albert Einstein College of Medicine in the Bronx measured the mental health of a group of 8- to 12-year-old children whose mothers had late-stage HIV/AIDS.
They found that all 129 children assessed five times over the course of the study had clinically significant psychiatric and/or behavioral symptoms during the study period.
Two thirds of the children had chronic psychological problems—that is, persistent symptoms at least three of the five times they were measured. “Most children were identified as having clinically significant symptoms by both themselves and their mother, although often they did not agree at the same time point or about the precise symptoms,” the investigators report.
Bauman and colleagues also note that while two-thirds of the children received mental health services during the study, less than a quarter did at any one time, and 28 percent of children with chronic clinically significant symptoms never received mental health care.
“As the numbers of children who are living with a mother with HIV/AIDS increase, the numbers of children who need routine mental health assessment, referral, and treatment will increase as well,” the investigators say.
“Pediatricians,” they note, “are in a strategic position to assist children of mothers with HIV, because they often know the maternal health history, they see children over time in their practice, and they can identify and refer children with mental health problems to pediatric mental health services that can address their complex needs.”
SOURCE: Pediatrics Electronic Pages, November 2007.