Wolicki Sara Beth, Bitsko Rebecca H, Danielson Melissa L, Holbrook Joseph R, Zablotsky Benjamin, Walkup John T, Woods Douglas W, Mink Jonathan W
Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Oak Ridge, TN.
Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
J Dev Behav Pediatr. 2019 Jul-Aug;40(6):407-414. doi: 10.1097/DBP.0000000000000667.
Describe the diagnostic process for Tourette syndrome (TS) based on parent report, as well as TS severity and associated impairment; the influence of common daily activities on tics; and the presence of co-occurring mental, behavioral, and developmental disorders among children in the United States.
Parent-report data from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome on 115 children ever diagnosed with TS were analyzed. Descriptive, unweighted analyses included frequencies and percentages, and means and standard deviations. Fisher's exact test and t-tests were calculated to determine statistically significant differences.
The mean age that tics were first noticed was 6.3 years, and, on average, TS was diagnosed at 7.7 years. The time from initially noticing tics to TS diagnosis averaged 1.7 years. The mean age when TS symptoms were most severe was 9.3 years. Tic severity was associated with impaired child functioning but not tic noticeability. Almost 70% of parents reported that fatigue and major transitions made their child's tics worse. Children with ever-diagnosed TS had a mean of 3.2 ever-diagnosed co-occurring mental, behavioral, or developmental disorders; a quarter (26.9%) had 5 or more co-occurring disorders.
In this sample of children with TS, the time to diagnosis averaged less than 2 years from when tics were initially noticed. More severe TS was associated with greater functional impairment, and co-occurring disorders were common among children with TS. This study provides insight into the current experiences of children with TS in the United States and their families.
描述基于家长报告的抽动秽语综合征(TS)诊断过程、TS严重程度及相关损害;日常常见活动对抽动的影响;以及美国儿童中同时存在的精神、行为和发育障碍情况。
对2014年注意力缺陷多动障碍及抽动秽语综合征诊断与治疗全国调查中115名曾被诊断为TS的儿童的家长报告数据进行分析。描述性、未加权分析包括频率和百分比、均值和标准差。计算费舍尔精确检验和t检验以确定统计学上的显著差异。
首次注意到抽动的平均年龄为6.3岁,TS平均诊断年龄为7.7岁。从最初注意到抽动到TS诊断的平均时间为1.7年。TS症状最严重时的平均年龄为9.3岁。抽动严重程度与儿童功能受损有关,但与抽动的可察觉性无关。近70%的家长报告称疲劳和重大转变会使孩子的抽动加重。曾被诊断为TS的儿童平均有3.2种曾被诊断出的同时存在的精神、行为或发育障碍;四分之一(26.9%)的儿童有5种或更多同时存在的障碍。
在这个TS儿童样本中,从最初注意到抽动到诊断的平均时间不到2年。更严重的TS与更大的功能损害相关,同时存在的障碍在TS儿童中很常见。本研究为美国TS儿童及其家庭的当前经历提供了见解。