Hesapçıoğlu Selma Tural, Tural Mustafa Kemal, Kandil Sema
Turk Psikiyatri Derg. 2013 Fall;24(3):158-67.
This study aimed to investigate comorbidity, and sociodemographic and clinical characteristics in children and adolescents with Tourette's syndrome (TS) and chronic motor or vocal tic disorder (CMVTD), and to determine the predictors of tic disorders.
In all, 57 children and adolescents with TS and CMVTD were compared with a control group. Data were obtained using the Yale Global Tic Severity Scale (YGTSS), Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Children's Depression Inventory (CDI), Screen for Child Anxiety-Related Disorders (SCARED), Maudsley Obsessive-Compulsive Inventory (MOCI), and Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL).
Mean age of the patients was 10.5 ± 2.4 years. In all, 56 (98.2%) of the patients had simple motor tics, 50 (87.7%) had complex motor tics, and 43 (75.4%) had vocal tics. Self-injurious behavior was observed in 24 (42.1%) patients. In total, 46 (80.7%) of the patients had ≥1 comorbid disorder. Among the observed comorbid disorders, attention deficit-hyperactivity disorder (ADHD) was the most common (observed in 40.4% of the patients), followed by obsessive-compulsive disorder (OCD) (19.3%). A higher-level of maternal education and absence of ADHD were associated with a reduction in the risk of a tic disorder. A family history of psychiatric disorder increased the risk of a tic disorder 5.61-fold, and nail biting increased the risk of a tic disorder 8.2-fold. Every 1-unit increase in CDI score increased the risk of a tic disorder by 12%.
Chronic tic disorders (CTDs) are often accompanied by other psychiatric disorders. Both child- and family-related factors are associated with the risk of developing a tic disorder. Determination of both the protective and risk factors would be beneficial for improving the mental health of the general public.
本研究旨在调查患有抽动秽语综合征（TS）和慢性运动或发声抽动障碍（CMVTD）的儿童及青少年的共病情况、社会人口学特征和临床特征，并确定抽动障碍的预测因素。
总共57名患有TS和CMVTD的儿童及青少年与一个对照组进行比较。使用耶鲁全球抽动严重程度量表（YGTSS）、基于图尔盖DSM-IV的破坏性行为障碍筛查与评定量表（T-DSM-IV-S）、儿童抑郁量表（CDI）、儿童焦虑相关障碍筛查量表（SCARED）、莫兹利强迫观念及强迫行为量表（MOCI）以及学龄儿童情感障碍和精神分裂症量表-目前及终生版（K-SADS-PL）获取数据。
患者的平均年龄为10.5±2.4岁。总共56名（98.2%）患者有简单运动性抽动，50名（87.7%）有复杂运动性抽动，43名（75.4%）有发声抽动。24名（42.1%）患者观察到有自伤行为。总共46名（80.7%）患者有一种或多种共病。在观察到的共病中，注意缺陷多动障碍（ADHD）最为常见（40.4%的患者有此症状），其次是强迫症（OCD）（19.3%）。母亲受教育程度较高以及没有ADHD与抽动障碍风险降低相关。精神疾病家族史使抽动障碍风险增加5.61倍，咬指甲使抽动障碍风险增加8.2倍。CDI评分每增加1个单位，抽动障碍风险增加12%。
慢性抽动障碍（CTD）常伴有其他精神疾病。儿童相关因素和家庭相关因素均与抽动障碍的发生风险相关。确定保护因素和风险因素均有助于改善公众心理健康。
