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Psychotic disorders in young adults with perinatally acquired HIV: a UK case series

Published online by Cambridge University Press:  13 November 2020

I. Mallik Open the ORCID record for I. Mallik [Opens in a new window] ,
T. Pasvol ,
G. Frize ,
S. Ayres ,
A. Barrera Open the ORCID record for A. Barrera [Opens in a new window] ,
S. Fidler Open the ORCID record for S. Fidler [Opens in a new window]  and
C. Foster
I. Mallik*
Affiliation:
Buckinghamshire Healthcare NHS Trust, Aylesbury, UK Department of Medicine, Imperial College London, London, UK, and Imperial College NIHR BRC, London, UK
T. Pasvol
Affiliation:
900 Clinic, Imperial College Healthcare NHS Trust, London, UK
G. Frize
Affiliation:
900 Clinic, Imperial College Healthcare NHS Trust, London, UK
S. Ayres
Affiliation:
900 Clinic, Imperial College Healthcare NHS Trust, London, UK
A. Barrera
Affiliation:
Oxford Health NHS Trust, Oxford, UK and Oxford University Department of Psychiatry, Oxford, UK
S. Fidler
Affiliation:
Department of Medicine, Imperial College London, London, UK, and Imperial College NIHR BRC, London, UK 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
C. Foster
Affiliation:
900 Clinic, Imperial College Healthcare NHS Trust, London, UK
*
Author for correspondence: I. Mallik, E-mail: indira.mallik13@imperial.ac.uk
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Abstract

Background

Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV.

Methods

We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184).

Results

In total, 12/184 (6.5%), median age 23 years (interquartile range 21–26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care.

Conclusion

The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16–34 years, which has been reported to be 0.5–1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.

Keywords

AdolescentsHIVperinatally acquired HIVpsychosissocial determinants of healthyoung adults
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 12 , September 2022 , pp. 2263 - 2269
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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