Clinical Characteristics of Children and Adolescents with a Primary Tic Disorder

Overview

Journal J Dev Phys Disabil

Specialty Rehabilitation Medicine

Date 2014 Jul 8

PMID 24999300

Citations 38

Authors

Matt W Specht

Douglas W Woods

John Piacentini

Lawrence Scahill

Sabine Wilhelm

Alan L Peterson

Susanna Chang

Hayden Kepley

Thilo Deckersbach

Christopher Flessner

Brian A Buzzella

Joseph F McGuire

Sue Levi-Pearl

John T Walkup

Affiliations

Soon will be listed here.

Abstract

The clinical characteristics and rates of co-occurring psychiatric conditions in youth seeking treatment for a chronic tic disorder (CTD) were examined. Children and adolescents ( = 126) with a primary CTD diagnosis were recruited for a randomized controlled treatment trial. An expert clinician established diagnostic status via semi-structured interview. Participants were male (78.6%), Caucasians (84.9%), mean age 11.7 years ( = 2.3) with moderate-to-severe tics who met criteria for Tourette's disorder (93.7%). Common co-occurring conditions included attention-deficit/hyperactivity disorder (ADHD; 26%), social phobia (21%), generalized anxiety disorder (20%), and obsessive-compulsive disorder (OCD; 19%). Motor and vocal tics with greater intensity, complexity, and interference were associated with increased impairment. Youth with a CTD seeking treatment for tics should be evaluated for non-OCD anxiety disorders in addition to ADHD and OCD. Despite the presence of co-occurring conditions, children with more forceful, complex, and/or directly interfering tics may seek treatment to reduce tic severity.

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References

Bloch M, Leckman J . Clinical course of Tourette syndrome. J Psychosom Res. 2009; 67(6):497-501. PMC: 3974606. DOI: 10.1016/j.jpsychores.2009.09.002. View

Scahill L, Chappell P, Kim Y, Schultz R, Katsovich L, Shepherd E . A placebo-controlled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. Am J Psychiatry. 2001; 158(7):1067-74. DOI: 10.1176/appi.ajp.158.7.1067. View

Scahill L, Leckman J, Schultz R, Katsovich L, Peterson B . A placebo-controlled trial of risperidone in Tourette syndrome. Neurology. 2003; 60(7):1130-5. DOI: 10.1212/01.wnl.0000055434.39968.67. View

Kendall P, Compton S, Walkup J, Birmaher B, Albano A, Sherrill J . Clinical characteristics of anxiety disordered youth. J Anxiety Disord. 2010; 24(3):360-5. PMC: 2838990. DOI: 10.1016/j.janxdis.2010.01.009. View

Bawden H, Stokes A, Camfield C, Camfield P, Salisbury S . Peer relationship problems in children with Tourette's disorder or diabetes mellitus. J Child Psychol Psychiatry. 1998; 39(5):663-8. View

Toren P, Weizman A, Ratner S, Cohen D, Laor N . Ondansetron treatment in Tourette's disorder: a 3-week, randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2005; 66(4):499-503. DOI: 10.4088/jcp.v66n0413. View

Wood J, Piacentini J, Bergman R, McCracken J, Barrios V . Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. J Clin Child Adolesc Psychol. 2002; 31(3):335-42. DOI: 10.1207/S15374424JCCP3103_05. View

Spencer T, Biederman J, Harding M, ODonnell D, Wilens T, Faraone S . Disentangling the overlap between Tourette's disorder and ADHD. J Child Psychol Psychiatry. 1998; 39(7):1037-44. View

. The Treatment for Adolescents With Depression Study (TADS): demographic and clinical characteristics. J Am Acad Child Adolesc Psychiatry. 2004; 44(1):28-40. DOI: 10.1097/01.chi.0000145807.09027.82. View

10.

Roessner V, Becker A, Banaschewski T, Freeman R, Rothenberger A . Developmental psychopathology of children and adolescents with Tourette syndrome--impact of ADHD. Eur Child Adolesc Psychiatry. 2008; 16 Suppl 1:24-35. DOI: 10.1007/s00787-007-1004-6. View

11.

Leckman J, Riddle M, Hardin M, Ort S, Swartz K, Stevenson J . The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry. 1989; 28(4):566-73. DOI: 10.1097/00004583-198907000-00015. View

12.

Hoberman H . Ethnic minority status and adolescent mental health services utilization. J Ment Health Adm. 1992; 19(3):246-67. DOI: 10.1007/BF02518990. View

13.

. Treatment of ADHD in children with tics: a randomized controlled trial. Neurology. 2002; 58(4):527-36. DOI: 10.1212/wnl.58.4.527. View

14.

Sukhodolsky D, Scahill L, Zhang H, Peterson B, King R, Lombroso P . Disruptive behavior in children with Tourette's syndrome: association with ADHD comorbidity, tic severity, and functional impairment. J Am Acad Child Adolesc Psychiatry. 2002; 42(1):98-105. DOI: 10.1097/00004583-200301000-00016. View

15.

Gilbert D, Batterson J, Sethuraman G, Sallee F . Tic reduction with risperidone versus pimozide in a randomized, double-blind, crossover trial. J Am Acad Child Adolesc Psychiatry. 2004; 43(2):206-14. DOI: 10.1097/00004583-200402000-00017. View

16.

Silver A, Shytle R, Sheehan K, Sheehan D, Ramos A, Sanberg P . Multicenter, double-blind, placebo-controlled study of mecamylamine monotherapy for Tourette's disorder. J Am Acad Child Adolesc Psychiatry. 2001; 40(9):1103-10. DOI: 10.1097/00004583-200109000-00020. View

17.

Silverman W, Saavedra L, Pina A . Test-retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry. 2001; 40(8):937-44. DOI: 10.1097/00004583-200108000-00016. View

18.

Carter A, ODonnell D, Schultz R, Scahill L, Leckman J, Pauls D . Social and emotional adjustment in children affected with Gilles de la Tourette's syndrome: associations with ADHD and family functioning. Attention Deficit Hyperactivity Disorder. J Child Psychol Psychiatry. 2000; 41(2):215-23. View

19.

Piacentini J, Woods D, Scahill L, Wilhelm S, Peterson A, Chang S . Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA. 2010; 303(19):1929-37. PMC: 2993317. DOI: 10.1001/jama.2010.607. View

20.

Kurlan R, McDermott M, Deeley C, Como P, Brower C, Eapen S . Prevalence of tics in schoolchildren and association with placement in special education. Neurology. 2001; 57(8):1383-8. DOI: 10.1212/wnl.57.8.1383. View