Clinical Characteristics of Children and Adolescents with a Primary Tic Disorder

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 (N = 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 (SD = 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.

Keywords: Anxiety; Comorbid; Impairment; Tics; Tourette’s disorder.

Figures

Fig. 1

Percent of participants meeting current DSM-IV-TR Diagnostic Criteria for each co-occurring psychiatric condition. Figure does not account for multiple co-occurring diagnoses. No participants were diagnosed with a co-occurring mood disorder. ADHD = attention-deficit/hyperactivity disorder; Soc Phobia = social phobia; GAD = generalized anxiety disorder; OCD = obsessive-compulsive disorder; Sep. Anx. = separation anxiety disorder; ODD = oppositional defiant disorder