Ankara ve İstanbul’daki Hıv/Aıds Merkezlerinde Takipli Hıv (+) Olan Çocuk ve Ergenlerin Ruh Sağlığı ve Bilişsel Fonksiyonları Açısından İncelenmesi ve Orta-Ağır Şiddetli Astımlı Çocuklarla Karşılaştırılması

Abstract

Karakok, B., An investigation of psychopathology and cognitive functioning of HIV infected children and adolescents in Ankara and Istanbul and comparison with children with moderate and severe asthma, Hacettepe University Faculty of Medicine, Thesis in Child and Adolescent Psychiatry, Ankara, 2017. Psychiatric problems among children with HIV infection have been described with recent studies. Yet disease, child, caregiver and socio-demographic factors associated with psychopathologies of these children are not fully understood. The aim of this research was to investigate psychopathologies and cognitive functions of HIV infected children and adolescents and factors associated with these objects. Results of HIV infected patients were compared with results of children and adolescents with asthma which was another chronic illness. 24 HIV + patients aged between 6-16 years old were assessed. Control group consisted of children with moderate and severe asthma who were similar in terms of age and gender. Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Lifetime Version (K-SADS-PL) was used for assessing the psychopathologies of enrolled children. Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) was used to evaluate the cognitive function. Children completed Children's Depression Inventory (CDI), Pediatric Quality of Life Questionarie (PedsQL), Rosenberg Self-Esteem Scale(RSS), Strenghts and Difficulties Questionarie (SDQ). Parents completed Parent SDQ and Parent PedsQL. The results revealed that both of groups had higher rates of psychopathology than general population. A significant difference was not found in rates of psychopathology between two groups. However, an increased rate of Attention Deficit Hyperactivity Disorder in HIV infected children was seen in this study. Full Scale IQ, Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed subscale scores for HIV infected children were all found to be significantly lower than children with asthma in WISC-IV evaluation. CD4 count and HIV RNA were not associated with both psychopathology and IQ scores. Scores of CDI, PedsQL, RSS, SDQ were not significantly different between two groups. A notable finding of the study was that although HIV infected children had high rates of psychopathology, none of these children had been evaluated for mental health problems by a specialist before the study. There is an urgent need for multidisciplinary approach to provide psychiatric examination of all HIV infected children at the time of primer HIV infection evaluation. Prospective researches are needed with a full understanding of psychosocial aspects of HIV and its effects on neurocognitive functions for interventions and preventions.