The Matta and Harry Freund Neuropsychiatric Tourette Clinic, Department of Child and Adolescent Psychiatry, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur Child Adolesc Psychiatry. 2020 May;29(5):617-624. doi: 10.1007/s00787-019-01386-6. Epub 2019 Aug 8.
Episodes of explosive anger and aggression are reported in patients with tic disorders and probably contribute to psychosocial stress and low quality of life. The source of these symptoms is controversial. The objective of the study was to study the relationship between tic disorders, their associated comorbidities, and aggressive behavior. The cohort included 47 children and adolescents (age 7-17 years) with Tourette syndrome or other chronic tic disorders attending a tertiary pediatric Tourette clinic. Associated psychopathology was assessed with the Yale Global Tic Severity Scale, Yale Brown Obsessive Compulsive Scale, Conners ADHD Rating Scale, Screen for Child Anxiety-Related Emotional Disorders, and Child Depression Inventory. Aggression was assessed with the Overt Aggression Scale and scores were compared with a group of 32 healthy age- and sex-matched children. There were no significant differences in aggression scores between the children with tic disorders and controls. Verbal aggression was the most prevalent type of aggression, found in 70% of the patients with tic disorders. The level of aggression was not correlated to tic severity. Comorbid attention-deficit hyperactivity disorder and obsessive-compulsive disorder increased the probability of aggressive behavior in patients with tic disorders. On regression analysis, the only significant predictor of aggression was the severity of attention-deficit hyperactivity disorder. This study suggests that there is no difference in aggressive behavior between children with tics without comorbidities and healthy children. It is possible that aggressive behavior in children with tic disorders is predominantly associated with comorbid attention-deficit hyperactivity disorder.
研究表明，患有抽动障碍的患者会出现爆发性愤怒和攻击行为，这可能会导致他们承受更多的社会心理压力，生活质量也更低。这些症状的根源目前还存在争议。本研究旨在探讨抽动障碍与其相关共病、攻击行为之间的关系。研究纳入了 47 名患有妥瑞氏症或其他慢性抽动障碍的儿童和青少年（年龄 7-17 岁），他们均在一家儿科抽动症诊所接受治疗。采用耶鲁总体抽动严重程度量表、耶鲁-布朗强迫量表、康纳斯多动症评定量表、儿童焦虑相关情绪障碍筛查量表和儿童抑郁量表评估相关精神病理学。采用外显攻击量表评估攻击行为，并与 32 名年龄和性别匹配的健康儿童的评分进行比较。抽动障碍患儿的攻击行为评分与对照组相比无显著差异。言语攻击是最常见的攻击行为类型，在 70%的抽动障碍患儿中存在。攻击水平与抽动严重程度无关。共患注意缺陷多动障碍和强迫症会增加抽动障碍患儿发生攻击行为的概率。回归分析表明，唯一显著预测攻击行为的因素是注意缺陷多动障碍的严重程度。本研究表明，无共病的抽动患儿与健康儿童的攻击行为无差异。抽动障碍患儿的攻击行为可能主要与共患的注意缺陷多动障碍有关。
