Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-17T14:54:15.481Z Has data issue: false hasContentIssue false
  • English
  • Français

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: [email protected]
Get access Rights & Permissions [Opens in a new window]

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
Check for updates
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abrams, E. J., Mellins, C. A., Bucek, A., Dolezal, C., Raymond, J., Wiznia, A., … Ng, Y. K. W. (2018). Behavioral health and adult milestones in young adults with perinatal HIV infection or exposure. Pediatrics, 142(3), e20180938. doi:10.1542/peds.2018-0938.CrossRefGoogle ScholarPubMed
Acuda, S. W., & Sebit, M. B. (1996). Serostatus surveillance testing of HIV-I infection among Zimbabwean psychiatric inpatients, in Zimbabwe. The Central African Journal of Medicine, 42(9), 254–257.Google ScholarPubMed
Al-Diwani, A. A. J., Pollak, T. A., Irani, S. R., & Lennox, B. R. (2017). Psychosis: An autoimmune disease? Immunology, 152(3), 388–401. doi:10.1111/imm.12795.CrossRefGoogle ScholarPubMed
Amminger, G. P., Harris, M. G., Conus, P., Lambert, M., Elkins, K. S., Yuen, H.-P., & McGorry, P. D. (2006). Treated incidence of first-episode psychosis in the catchment area of EPPIC between 1997 and 2000. Acta Psychiatrica Scandinavica, 114(5), 337–345. doi:10.1111/j.1600-0447.2006.00790.x.CrossRefGoogle ScholarPubMed
Ashby, J., Foster, C., Garvey, L., Wan, T., Allsop, J., Paramesparan, Y., … Winston, A. (2015). Cerebral function in perinatally HIV-infected young adults and their HIV-uninfected sibling controls. HIV Clinical Trials, 16(2), 81–87. doi:10.1179/1528433614Z.0000000003.CrossRefGoogle ScholarPubMed
Bebbington, P. E., Bhugra, D., Brugha, T., Singleton, N., Farrell, M., Jenkins, R., … Meltzer, H. (2004). Psychosis, victimisation and childhood disadvantage. British Journal of Psychiatry, 185(03), 220–226. doi:10.1192/bjp.185.3.220.CrossRefGoogle ScholarPubMed
Belcher, R., & Marcangelo, M. (2017). Efavirenz precipitating hallucinations in a patient with an undetected psychotic prodrome. AIDS (London, England), 31(18), 2561–2562. doi:10.1097/QAD.0000000000001657.CrossRefGoogle Scholar
Cardno, A. G., Marshall, E. J., Coid, B., Macdonald, A. M., Ribchester, T. R., Davies, N. J., … Murray, R. M. (1999). Heritability estimates for psychotic disorders. Archives of General Psychiatry, 56(2), 162. doi:10.1001/archpsyc.56.2.162.CrossRefGoogle ScholarPubMed
Centers for Disease Control (CDC). (1987). Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. Council of State and Territorial Epidemiologists; AIDS Program, Center for Infectious Diseases. Morbidity and Mortality Weekly Report, 36(Suppl 1), 1S–15S.Google Scholar
Chappell, E., Lyall, H., Riordan, A., Thorne, C., Foster, C., Butler, K., … O'Callaghan, M. (2019). The cascade of care for children and adolescents with HIV in the UK and Ireland, 2010 to 2016. Journal of the International AIDS Society, 22(9), 8997817. doi:10.1002/jia2.25379.CrossRefGoogle Scholar
Collins, P. Y., Berkman, A., Mestry, K., & Pillai, A. (2009). HIV Prevalence among men and women admitted to a South African public psychiatric hospital. AIDS Care, 21(7), 863–867. doi:10.1080/09540120802626188.CrossRefGoogle ScholarPubMed
Collins, I. J., Foster, C., Tostevin, A., Tookey, P., Riordan, A., Dunn, D., … Judd, A. (2017). Clinical Status of adolescents with perinatal HIV at transfer to adult care in the UK/Ireland. Clinical Infectious Diseases, 64(8), 1105–1112. doi:10.1093/cid/cix063.CrossRefGoogle ScholarPubMed
Cooper, C., Morgan, C., Byrne, M., Dazzan, P., Morgan, K., Hutchinson, G., … Fearon, P. (2008). Perceptions of disadvantage, ethnicity and psychosis. British Journal of Psychiatry, 192(03), 185–190. doi:10.1192/bjp.bp.107.042291.CrossRefGoogle ScholarPubMed
Cooper, S.-A., Smiley, E., Morrison, J., Allan, L., Williamson, A., Finlayson, J., … Mantry, D. (2007). Psychosis and adults with intellectual disabilities. Social Psychiatry and Psychiatric Epidemiology, 42(7), 530–536. doi:10.1007/s00127-007-0197-9.CrossRefGoogle ScholarPubMed
Dalman, C., Allebeck, P., Gunnell, D., Harrison, G., Kristensson, K., Lewis, G., … Karlsson, H. (2008). Infections in the CNS during childhood and the risk of subsequent psychotic illness: A cohort study of more than One million Swedish subjects. American Journal of Psychiatry, 165(1), 59–65. doi:10.1176/appi.ajp.2007.07050740.CrossRefGoogle ScholarPubMed
Department of Communities and Local Government (2015). The English Index of Multiple Deprivation (IMD) 2015-Guidance. Retrieved from https://www.gov.uk/government/statistics/english-indices-of-deprivation-2015.Google Scholar
De Ronchi, D., Faranca, I., Forti, P., Ravaglia, G., Borderi, M., Manfredi, R., & Volterra, V. (2000). Development of acute psychotic disorders and HIV-1 infection. The International Journal of Psychiatry in Medicine, 30(2), 173–183. doi:10.2190/PLGX-N48F-RBHJ-UF8K.CrossRefGoogle ScholarPubMed
Ellul, P., Groc, L., Tamouza, R., & Leboyer, M. (2017). The clinical challenge of autoimmune psychosis: Learning from anti-NMDA receptor autoantibodies. Frontiers in Psychiatry, 8, 54. doi:10.3389/fpsyt.2017.00054.CrossRefGoogle ScholarPubMed
Feigenson, K. A., Kusnecov, A. W., & Silverstein, S. M. (2014). Inflammation and the two-hit hypothesis of schizophrenia. Neuroscience & Biobehavioral Reviews, 38, 72–93. doi:10.1016/j.neubiorev.2013.11.006.CrossRefGoogle ScholarPubMed
Fosse, R., Joseph, J., & Richardson, K. (2015, April 28). A critical assessment of the equal-environment assumption of the twin method for schizophrenia. Frontiers in Psychiatry, 6, 62. doi:10.3389/fpsyt.2015.00062.CrossRefGoogle Scholar
Foster, C., Ayers, S., McDonald, S., Frize, G., Chhabra, S., Pasvol, T. J., & Fidler, S. (2020). Clinical outcomes post transition to adult services in young adults with perinatally acquired HIV infection: Mortality, retention in care and viral suppression. AIDS (London, England), 34(2), 261–266. doi:10.1097/QAD.0000000000002410.CrossRefGoogle ScholarPubMed
Foster, R., Olajide, D., & Everall, I. P. (2003). Antiretroviral therapy-induced psychosis: Case report and brief review of the literature. HIV Medicine, 4(2), 139–144. doi:10.1046/j.1468-1293.2003.00142.x.CrossRefGoogle ScholarPubMed
González-Scarano, F., & Martín-García, J. (2005). The neuropathogenesis of AIDS. Nature Reviews Immunology, 5(1), 69–81. doi:10.1038/nri1527.CrossRefGoogle Scholar
Hastings, P. D., Serbin, L. A., Bukowski, W., Helm, J. L., Stack, D. M., Dickson, D. J., … Schwartzman, A. E. (2019). Predicting psychosis-spectrum diagnoses in adulthood from social behaviors and neighborhood contexts in childhood. Development and Psychopathology, 32(2), 1–15. doi:10.1017/S095457941900021X.Google Scholar
Helleberg, M., Pedersen, M. G., Pedersen, C. B., Mortensen, P. B., & Obel, N. (2015). Associations between HIV and schizophrenia and their effect on HIV treatment outcomes: A nationwide population-based cohort study in Denmark. The Lancet HIV, 2(8), e344–e350. doi:10.1016/S2352-3018(15)00089-2.CrossRefGoogle ScholarPubMed
Hilker, R., Helenius, D., Fagerlund, B., Skytthe, A., Christensen, K., Werge, T. M., … Glenthøj, B. (2018). Heritability of schizophrenia and schizophrenia spectrum based on the Nationwide Danish Twin Register. Biological Psychiatry, 83(6), 492–498. doi:10.1016/j.biopsych.2017.08.017.CrossRefGoogle ScholarPubMed
Jones, P., Rodgers, B., Murray, R., & Marmot, M. (1994). Child development risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet (London, England), 344(8934), 1398–1402. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7968076.CrossRefGoogle ScholarPubMed
Judd, A., Le Prevost, M., Melvin, D., Arenas-Pinto, A., Parrott, F., & Winston, A., … Adolescents and Adults Living With Perinatal HIV (AALPHI) Steering Committee (2016). Cognitive function in young persons with and without perinatal HIV in the AALPHI cohort in England: Role of Non–HIV-related factors. Clinical Infectious Diseases, 63(10), 1380–1387. doi:10.1093/cid/ciw568.CrossRefGoogle ScholarPubMed
Kane, J. M., Kishimoto, T., & Correll, C. U. (2013). Non-adherence to medication in patients with psychotic disorders: Epidemiology, contributing factors and management strategies. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 12(3), 216–226. doi:10.1002/wps.20060.CrossRefGoogle ScholarPubMed
Laughton, B., Cornell, M., Boivin, M., & Van Rie, A. (2013). Neurodevelopment in perinatally HIV-infected children: A concern for adolescence. Journal of the International AIDS Society, 16(1), 18603. doi:10.7448/IAS.16.1.18603.CrossRefGoogle ScholarPubMed
Lauronen, E., Miettunen, J., Veijola, J., Karhu, M., Jones, P. B., & Isohanni, M. (2007). Outcome and its predictors in schizophrenia within the northern Finland 1966 birth cohort. European Psychiatry, 22(2), 129–136. doi:10.1016/j.eurpsy.2006.07.001.CrossRefGoogle ScholarPubMed
Le Prevost, M., Arenas-Pinto, A., Melvin, D., Parrott, F., Foster, C., & Ford, D., … Committee, on behalf of the A. and A. L. with P. H. (AALPHI) S. (2018). Anxiety and depression symptoms in young people with perinatally acquired HIV and HIV affected young people in England. AIDS Care, 30(8), 1040–1049. doi:10.1080/09540121.2018.1441972.CrossRefGoogle ScholarPubMed
Lundberg, P., Nakasujja, N., Musisi, S., Thorson, A., Cantor-Graae, E., & Allebeck, P. (2013). HIV Prevalence in persons with severe mental illness in Uganda: A cross-sectional hospital-based study. International Journal of Mental Health Systems, 7(1), 20. doi:10.1186/1752-4458-7-20.CrossRefGoogle ScholarPubMed
Maling, S., Todd, J., Van der Paal, L., Grosskurth, H., & Kinyanda, E. (2011). HIV-1 seroprevalence and risk factors for HIV infection among first-time psychiatric admissions in Uganda. AIDS Care, 23(2), 171–178. doi:10.1080/09540121.2010.498939.CrossRefGoogle ScholarPubMed
McAllister, T. W. (1998). Traumatic brain injury and psychosis: What is the connection? Seminars in Clinical Neuropsychiatry, 3(3), 211–223. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10085209.Google ScholarPubMed
McManus, S, Bebbington, P, Jenkins, R, & Brugha, T. (Eds.) (2016). Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. Retrieved from https://files.digital.nhs.uk/pdf/q/3/mental_health_and_wellbeing_in_england_full_report.pdf.Google Scholar
Mellins, C. A., Elkington, K. S., Leu, C. S., Santamaria, E. K., Dolezal, C., Wiznia, A., … Abrams, E. J. (2012). Prevalence and change in psychiatric disorders among perinatally HIV-infected and HIV-exposed youth. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 24(8), 953–962. doi:10.1080/09540121.2012.668174.Google ScholarPubMed
Mellins, C. A., & Malee, K. M. (2013). Understanding the mental health of youth living with perinatal HIV infection: Lessons learned and current challenges. Journal of the International AIDS Society, 16(1), 18593. doi:10.7448/IAS.16.1.18593.CrossRefGoogle ScholarPubMed
Ministry of Housing, C. & L. G. (2015). English Indices of Deprivation 2015: Postcode Lookup. Retrieved May 10, 2019, from http://imd-by-postcode.opendatacommunities.org/.Google Scholar
Nozyce, M. L., Lee, S. S., Wiznia, A., Nachman, S., Mofenson, L. M., Smith, M. E., … Pelton, S. (2006). A behavioral and cognitive profile of clinically stable HIV-infected children. Pediatrics, 117(3), 763–770. doi:10.1542/peds.2005-0451.CrossRefGoogle ScholarPubMed
O'Donoghue, B., Lyne, J., Madigan, K., Lane, A., Turner, N., O'Callaghan, E., & Clarke, M. (2015). Environmental factors and the age at onset in first episode psychosis. Schizophrenia Research, 168(1–2), 106–112. doi:10.1016/J.SCHRES.2015.07.004.CrossRefGoogle ScholarPubMed
Opondo, P. R., Ho-Foster, A. R., Ayugi, J., Hatitchki, B., Pumar, M., Bilker, W. B., … Evans, D. L. (2018). HIV Prevalence among hospitalized patients at the main psychiatric referral hospital in Botswana. AIDS and Behavior, 22(5), 1503–1516. doi:10.1007/s10461-017-1878-3.CrossRefGoogle ScholarPubMed
Paramesparan, Y., Garvey, L. J., Ashby, J., Foster, C. J., Fidler, S., & Winston, A. (2010). High rates of asymptomatic neurocognitive impairment in vertically acquired HIV-1–infected adolescents surviving to adulthood. JAIDS Journal of Acquired Immune Deficiency Syndromes, 55(1), 134–136. doi:10.1097/QAI.0b013e3181d90e8c.CrossRefGoogle Scholar
Popovic, D., Schmitt, A., Kaurani, L., Senner, F., Papiol, S., Malchow, B., … Falkai, P. (2019). Childhood trauma in schizophrenia: Current findings and research perspectives. Frontiers in Neuroscience, 13, 274. doi:10.3389/fnins.2019.00274.CrossRefGoogle ScholarPubMed
Qassem, T., Bebbington, P., Spiers, N., McManus, S., Jenkins, R., & Dein, S. (2015). Prevalence of psychosis in black ethnic minorities in Britain: Analysis based on three national surveys. Social Psychiatry and Psychiatric Epidemiology, 50(7), 1057–1064. doi:10.1007/s00127-014-0960-7.CrossRefGoogle ScholarPubMed
Ryscavage, P. A., Anderson, E. J., Sutton, S. H., Reddy, S., & Taiwo, B. (2011). Clinical outcomes of adolescents and young adults in adult HIV care. JAIDS Journal of Acquired Immune Deficiency Syndromes, 58(2), 193–197. doi:10.1097/QAI.0B013E31822D7564.CrossRefGoogle Scholar
Selten, J.-P., van der Ven, E., Rutten, B. P. F., & Cantor-Graae, E. (2013). The social defeat hypothesis of schizophrenia: An update. Schizophrenia Bulletin, 39(6), 1180–1186. doi:10.1093/schbul/sbt134.CrossRefGoogle ScholarPubMed
Selten, J.-P., van der Ven, E., & Termorshuizen, F. (2019). Migration and psychosis: A meta-analysis of incidence studies. Psychological Medicine, 50, 303–313. doi:10.1017/S0033291719000035.CrossRefGoogle ScholarPubMed
Slogrove, A. L., Schomaker, M., Davies, M.-A., Williams, P., Balkan, S., Ben-Farhat, J., … Leroy, V. (2018). The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis. PLOS Medicine, 15(3), e1002514. doi:10.1371/journal.pmed.1002514.Google ScholarPubMed
Stangeland, H., Orgeta, V., & Bell, V. (2018). Poststroke psychosis: A systematic review. Journal of Neurology, Neurosurgery, and Psychiatry, 89(8), 879–885. doi:10.1136/jnnp-2017-317327.CrossRefGoogle ScholarPubMed
Tang, C., Goldsamt, L., Meng, J., Xiao, X., Zhang, L., Williams, A. B., & Wang, H. (2020). Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: A systematic review and meta-analysis. BMJ Open, 10(4), e032435. doi:10.1136/bmjopen-2019-032435.CrossRefGoogle ScholarPubMed
Trotta, A., Di Forti, M., Mondelli, V., Dazzan, P., Pariante, C., David, A., … Fisher, H. L. (2013). Prevalence of bullying victimisation amongst first-episode psychosis patients and unaffected controls. Schizophrenia Research, 150(1), 169–175. doi:10.1016/j.schres.2013.07.001.CrossRefGoogle ScholarPubMed
Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., … Bentall, R. P. (2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin, 38(4), 661–671. doi:10.1093/schbul/sbs050.CrossRefGoogle Scholar
Vreeman, R. C., McCoy, B. M., & Lee, S. (2017). Mental health challenges among adolescents living with HIV. Journal of the International AIDS Society, 20(0), 21497. doi:10.7448/IAS.20.4.21497.CrossRefGoogle ScholarPubMed
Wahlberg, K. E., Wynne, L. C., Oja, H., Keskitalo, P., Pykäläinen, L., Lahti, I., … Tienari, P. (1997). Gene-environment interaction in vulnerability to schizophrenia: Findings from the Finnish Adoptive Family Study of Schizophrenia. American Journal of Psychiatry, 154(3), 355–362. doi:10.1176/ajp.154.3.355.Google ScholarPubMed
World Health Organization (2004). ICD-10: International statistical classification of diseases and related health problems: tenth revision; 2nd ed. World Health Organization. Retrieved from https://apps.who.int/iris/handle/10665/42980.Google Scholar