Sleep-Related Problems in Youth with TouretteÕs Syndrome and Chronic Tic Disorder

This study reports the prevalence and symptom correlates of sleep related problems (SRPs) in a sample of young people with TouretteÕs Syndrome (TS) or Chronic Tic Disorder. Fifty-six young people (and one of their parents) with a tic disorder were administered the Yale Global Tic Severity Scale. Children completed the Pediatric Quality of Life Inventory and Multidimensional Anxiety Scale for Children. Parents completed the Pediatric Quality of Life Inventory -Parent Proxy and Child Behavior Checklist. Overall, SRPs were widely endorsed, with 80.4% experiencing at least one SRP and 19.7% experiencing four or more. SRPs were negatively associated with quality of life and positively associated with internalising and externalising behaviours. Children with comorbid anxiety disorders had more SRPs than those without. We conclude by recommending that SRPs be assessed in young people with tics (particularly when comorbid anxiety is present), and highlight the role of psychotherapeutic and pharmacological intervention in reducing SRPs. Key Practitioner Message: • Sleep related problems (SRPs) are relatively common in young people with tic disorders and suggest the need for SRPs to be included in the comprehensive assessment and management of young people with tics • SRPs were positively linked to both anxiety and internalising and externalising behaviours and negatively related to child-and parent-rated quality of life • Should SRPs be present and clinically meaningful, treatment per evidence-based guidelines may be warrante

Depression and adherence to antiretroviral therapy in low-, middle- and high-income countries : a systematic review and meta-analysis

We investigated the associations between depressive symptoms and adherence to antiretroviral therapy (ART) among people living with HIV (PLHIV). We searched the PubMed, EMBASE and Cochrane CENTRAL databases for studies that reported an association between depression and adherence to ART as a primary or secondary outcome. We used a random-effect model to pool the risk estimates from the individual studies. The odds ratio (OR) with their 95 % CIs were used as summary estimates. Of 2861 citations, 111 studies that recruited 42,366 PLHIV met our inclusion criteria. When reported, the rate of PLHIV with depressive symptoms ranged from 12.8 to 78 % and the proportion of PLHIV who achieved good adherence (≥80 %) ranged from 20 to 98 %. There were no significant differences in rate of depressive symptoms in PLHIV by country income group; however, the proportion of PLHIV who achieved good adherence was significantly higher in lower-income countries (as defined in the 2012 World Bank Country Income Groups) (pooled rate = 86 %) compared to higher-income countries (pooled rate = 67.5 %; p < .05). We found that the likelihood of achieving good ART adherence was 42 % lower among those with depressive symptoms compared to those without (pooled OR = 0.58, 95 % CI 0.55 to 0.62). The relationship between depressive symptoms and adherence to ART was consistent across the country’s income group, study design and adherence rates. We found that the magnitude of the association significantly decreases with more recent publications and increasing study sample size. The higher the prevalence of depressive symptoms of PLHIV recruited in the studies, the lower the likelihood of achieving good adherence to ART. In conclusion, the likelihood of achieving good adherence was lower among those with depressive symptoms compared to those without