Rates, types and co-occurrence of emotional and behavioural disorders among perinatally HIV-infected youth in Uganda: the CHAKA study

  • Eugene KinyandaEmail author
  • Tatiana T. Salisbury
  • Jonathan Levin
  • Noeline Nakasujja
  • Richard S. Mpango
  • Catherine Abbo
  • Soraya Seedat
  • Ricardo Araya
  • Seggane Musisi
  • Kenneth D. Gadow
  • Vikram Patel
Original Paper



To describe the rates, types and comorbidity of emotional and behavioural disorders among perinatally HIV-infected children and adolescents attending care at five HIV youth clinics in Central and Southwestern Uganda.


1339 CA-HIV attending care at HIV youth clinics in Uganda were interviewed using the DSM-5-based Child and Adolescent Symptom Inventory-5 (CASI-5; caregiver reported) and the Youth Inventory-4R (YI-4R; youth reported). Prevalence, risk factors and comorbidity for psychiatric disorders were estimated using logistic regression models.


According to caregiver or youth report, the prevalence of ‘any DSM-5 psychiatric disorder’ was 17.4% (95% CI 15.4–19.5%), while that of ‘any behavioural disorder’ was 9.6% (95% CI 8.1–11.2%) and that of ‘any emotional disorder’ was 11.5% (95% CI 9.9–13.3%). The most prevalent behavioural disorder was attention deficit hyperactivity disorder (5.3%), while the most prevalent emotional disorder was separation anxiety disorder (4.6%). The statistically significant risk factors were: for behavioural disorders, sex (more among males than females) and age group (more among adolescents than among children); for emotional disorders, age group (more among adolescents than among children) and the caregiver’s highest educational attainment (more among CA-HIV with caregivers with secondary education and higher, than among CA-HIV with caregivers with no formal education or only primary level education). About a quarter (24.5%) of CA-HIV with at least one emotional disorder and about a third (33.5%) of the CA-HIV with at least one behavioural disorder had a comorbid psychiatric disorder.


There was a considerable burden of psychiatric disorders among CA-HIV that spanned a broad spectrum and showed considerable comorbidity.


Children Adolescents HIV Emotional and behavioural problems Psychiatric disorder Africa 



We would like to acknowledge the work and support provided by the staff of the Mental Health Project at the MRC/UVRI & LSHTM Uganda Research Unit. We would also like to acknowledge the support and corporation of children/adolescents, caregivers and management of The AIDS Support Organisation (TASO) clinic (Masaka), Kitovu Mobile AIDS organisation (Masaka), The Uganda Cares clinic (Masaka), Joint Clinical Research Centre clinic (Kampala) and Nsambya Home care Department (Kampala). This work was supported by a Medical Research Council / Department for International Development—African Leadership Award to Eugene Kinyanda, Number MR/L004623/1.

Compliance with ethical standards

Conflict of interest

No conflict of interest to declare.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Eugene Kinyanda
    • 1
    • 2
    Email author
  • Tatiana T. Salisbury
    • 3
  • Jonathan Levin
    • 4
  • Noeline Nakasujja
    • 2
  • Richard S. Mpango
    • 1
  • Catherine Abbo
    • 2
  • Soraya Seedat
    • 5
  • Ricardo Araya
    • 3
  • Seggane Musisi
    • 2
  • Kenneth D. Gadow
    • 6
  • Vikram Patel
    • 7
  1. 1.Mental Health ProjectMRC/UVRI & LSHTM Uganda Research Unit/Senior Wellcome Trust FellowshipEntebbeUganda
  2. 2.Department of PsychiatryMakerere College of Health SciencesKampalaUganda
  3. 3.Health Service and Population Research Department, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  4. 4.School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  5. 5.Department of PsychiatryStellenbosch UniversityMatielandSouth Africa
  6. 6.Department of PsychiatryStony Brook UniversityNew YorkUSA
  7. 7.Department of Global Health and Social MedicineHarvard Medical SchoolBostonUSA

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