Psychiatric diagnoses in adolescents seropositive for the human immunodeficiency virus

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 highrisk sexual behaviors and substance use that increases the risk for HIV infection in adolescent populations.