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儿童抽动障碍的患病率及临床特征

The Prevalence of Tic Disorders and Clinical Characteristics in Children.

作者信息

Scahill Lawrence, Specht Matthew, Page Christopher

机构信息

Emory School of Medicine, Marcus Autism Center, Atlanta, GA.

Johns Hopkins School of Medicine, Baltimore, MD.

出版信息

J Obsessive Compuls Relat Disord. 2014 Oct 1;3(4):394-400. doi: 10.1016/j.jocrd.2014.06.002.

Abstract

BACKGROUND

Prevalence is a simple statement about the frequency of a disease in the population. For many medical conditions, including Tourette syndrome, there are true cases that have not been previously diagnosed due to problems of access to appropriate clinical services. Therefore, to obtain a trustworthy estimate of prevalence, it is necessary to go beyond cases identified in clinical settings and evaluate community samples.

METHOD

We reviewed 11 community surveys in children with Tourette syndrome (TS) published since 2000. We also examined the frequency of co-occurring psychiatric conditions in community samples and large clinically-ascertained samples.

RESULTS

Transient tics are relatively common affecting as many as 20% of school-age children. The 11 studies reviewed here offer a wide range of estimates from 2.6 to 38 per 1000 children for TS. Six studies provide estimates in a narrower range from 4.3 to 7.6 per 1000, but the confidence interval around this narrower range remains wide. Six studies provided results on chronic tic disorders ranging from 3 to 50 per 1000 for Chronic Motor Tic Disorder and 2.5 to 9.4 per 1000 for Chronic Vocal Tic Disorder. Community samples and large clinically-ascertained samples consistently show high rates of ADHD, disruptive behavior and anxiety disorders in children with TS.

CONCLUSIONS

The wide range of prevalence estimates for TS and chronic tic disorders is likely due to differences in sample size and assessment methods. The best estimate of prevalence for TS in school-age children is likely to fall between 4 and 8 cases per 1000. Clinical assessment of children with chronic tic disorders warrants examination of other problems such as ADHD, disruptive behavior and anxiety.

摘要

背景

患病率是关于人群中疾病发生频率的一个简单表述。对于包括妥瑞氏症在内的许多医学病症,由于难以获得适当的临床服务,存在一些此前未被诊断出的真实病例。因此,为了获得可靠的患病率估计值,有必要超越临床环境中识别出的病例,对社区样本进行评估。

方法

我们回顾了自2000年以来发表的11项关于妥瑞氏症(TS)儿童的社区调查。我们还研究了社区样本和大型临床确诊样本中共发精神病症的发生频率。

结果

短暂性抽动相对常见,影响多达20%的学龄儿童。此处回顾的11项研究给出了每1000名儿童中TS病例数从2.6至38的广泛估计范围。六项研究给出的估计范围较窄,为每1000名儿童中4.3至7.6例,但该较窄范围的置信区间仍然很宽。六项研究给出了慢性抽动障碍的结果,慢性运动性抽动障碍每1000名儿童中有3至50例,慢性发声性抽动障碍每1000名儿童中有2.5至9.4例。社区样本和大型临床确诊样本一致显示,TS儿童中注意力缺陷多动障碍、破坏性行为和焦虑症的发生率很高。

结论

TS和慢性抽动障碍患病率估计值的广泛差异可能是由于样本量和评估方法的不同。学龄儿童中TS患病率的最佳估计值可能在每1000例中有4至8例之间。对患有慢性抽动障碍的儿童进行临床评估时,有必要检查其他问题,如注意力缺陷多动障碍、破坏性行为和焦虑症。

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