The impact of common mental disorders among caregivers living with HIV on child cognitive development in Zimbabwe

ABSTRACT

This paper aimed to assess the impact of maternal common mental disorders (CMD) among caregivers living with HIV on the cognitive functioning of their child. Data were collected at baseline and 12 months follow-up from mother–child dyads recruited as part of an ongoing trial in Zimbabwe. Symptoms of CMD were assessed using the Shona Symptom Questionnaire. Mixed-effects linear regression was used to assess child cognitive scores at follow-up (using the Mullen Scales of Early Learning) in relation to caregiver CMD prevalence over 12 months. At baseline, caregivers reporting CMD (n = 230; 40.1%) were less likely to have completed higher education (46.9% vs. 56.9%; p = 0.02), more likely to be unmarried (27.8% vs. 16.0%; p < 0.01), and experience food insecurity (50.0% vs. 29.4%; p < 0.01) compared to the group without CMD (n = 344). There were 4 CMD patterns over time: (i) Emerging CMD (n = 101; 19.7% of caregivers) defined as those who were below the cut-off at baseline, and above it at 12 months; (ii) Improving CMD (n = 76; 14.8%) defined as those who reported CMD at baseline, and were below the cut-off by follow-up; (iii) No CMD (n = 206; 40.1%) defined as those who did not report CMD symptoms at either time point; and (iv) Chronic CMD (n = 131; 25.5%) defined as those who reported CMD above the cut-off at both time points. Children of caregivers with chronic CMD (n = 131, 25.5%) had lower receptive language scores (aMD:−2.81, 95%CI −5.1 to −0.6; p = 0.05) compared to the reference group with no CMD (n = 206, 40.1%). Exposure to caregiver CMD over a prolonged period may affect child receptive vocabulary skills.

KEYWORDS:

• Common mental disorders
• Maternal depression
• Child cognitive development
• HIV positive
• Sub-Saharan Africa

Acknowledgements

We would like to thank our various partners USAID-PEPFAR, the PEPFAR OVC Technical Working Group, CeSHHAR, and World Education Zimbabwe (project implementing partner). We would also like to thank the families and children who participated in the trial.

Disclosure statement

No potential conflict of interest was reported by the author(s).

ORCID

Andrea M. Rehman http://orcid.org/0000-0001-9967-5822

Additional information

Funding

The funding partners for the study are USAID-PEPFAR, funded under the Orphans and Vulnerable Children Special Initiative.