Association of adult caregiver depression with developmental disorder likelihood in Ugandan children perinatally exposed and unexposed to HIV

We assessed whether higher caregiver depression is associated with increased likelihood of caregivers rating their children as screening positive for developmental disorders-autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder, emotional behavioral disorder, and functional impairment (FI)-among Ugandan children perinatally exposed and unexposed to HIV. Children and their primary caregivers were followed for 12 months. Caregiver depression was measured using the Hopkins Symptom Checklist-25 and categorized as low, moderate, or high based on terciles. Child developmental indices were derived from the Behavioral Assessment System for Children (third edition) at 0, 6, and 12 months. Multivariable linear regression estimated mean differences (MDs) in disorder indices with 95% confidence intervals (CIs) by caregiver depression level. Compared with highly depressed caregivers, those with low depression reported consistently lower ASD risk scores (MD: -0.35 to -0.32; 95% CI: -0.60 to -0.08). Similar trends were observed for FI (MD: -0.56 to -0.31; 95% CI: -0.81 to -0.06). Moderate depression was associated with modestly lower FI risk at baseline and 6 months but not at 12 months. Overall, higher caregiver depressive symptoms were linked to greater perceived child disorder risk. Evaluating caregiver depression alongside child screening may improve interpretation of developmental risk assessments.