Department of Neurology, Vanderbilt University Medical Center, Nashville (Isaacs, Eckland); Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville (Isaacs); Department of Medicine, Health, and Society, Vanderbilt University, Nashville (Narapareddy); Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, and Department of Pediatric Neurology, Johns Hopkins Children's Center, Baltimore (Riordan).
J Neuropsychiatry Clin Neurosci. 2023 Fall;35(4):352-360. doi: 10.1176/appi.neuropsych.20220197. Epub 2023 Apr 24.
Among adults with Tourette syndrome, depression and anxiety symptoms are widely prevalent and consistently associated with poor quality of life. Important knowledge gaps remain regarding mood and anxiety dimensions of the adult Tourette syndrome phenotype. Taking a dimensional approach, this study sought to determine the prevalence, severity, and clinical correlates of depression and anxiety symptoms in a clinical sample of adults with Tourette syndrome and other chronic tic disorders.
A retrospective chart review was conducted of all adults with a chronic tic disorder presenting to a tertiary care Tourette syndrome clinic between December 2020 and July 2022. Information extracted during chart review included data from scales administered as part of routine care: Quality of Life in Neurological Disorders (Neuro-QoL) Depression Short Form, Neuro-QoL Anxiety Short Form, Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale, Dimensional Obsessive-Compulsive Scale, and Yale Global Tic Severity Scale. Relationships between variables were examined by conducting between-group, correlation, and multivariable regression analyses.
Data from 120 adult patients with a chronic tic disorder (77 men and 43 women) were analyzed. Neuro-QoL Anxiety scores were elevated in 66% of the cohort; Neuro-QoL Depression scores were elevated in 26%. Neuro-QoL Anxiety scores were significantly higher than general population norms, whereas Neuro-QoL Depression scores were not. After adjustment for covariates, depressive and anxiety symptom severity scores were significantly associated with each other and with obsessive-compulsive disorder symptom severity but not with tic severity. Sex-based differences emerged in the analyses.
Among adults with chronic tic disorder, anxiety symptoms were more prevalent and severe than depressive symptoms, co-occurring psychiatric symptoms were more tightly linked with each other than with tic severity, and sex-based differences were evident.
在患有图雷特综合征的成年人中，抑郁和焦虑症状普遍存在，并与生活质量差密切相关。对于成人图雷特综合征表型的情绪和焦虑维度，仍存在重要的知识空白。本研究采用维度方法，旨在确定在一个患有图雷特综合征和其他慢性抽动障碍的临床样本中，抑郁和焦虑症状的患病率、严重程度和临床相关性。
对 2020 年 12 月至 2022 年 7 月期间在三级护理图雷特综合征诊所就诊的所有患有慢性抽动障碍的成年人进行了回顾性图表审查。图表审查中提取的信息包括作为常规护理一部分所使用的量表的数据：神经疾病生活质量量表（Neuro-QoL）抑郁简短量表、Neuro-QoL 焦虑简短量表、成人注意缺陷/多动障碍自我报告筛查量表、维度强迫症量表和耶鲁全球抽动严重程度量表。通过进行组间、相关性和多变量回归分析来检查变量之间的关系。
对 120 名患有慢性抽动障碍的成年患者（77 名男性和 43 名女性）的数据进行了分析。队列中有 66%的患者神经-QoL 焦虑评分升高；26%的患者神经-QoL 抑郁评分升高。神经-QoL 焦虑评分明显高于一般人群的正常值，而神经-QoL 抑郁评分则没有。在调整协变量后，抑郁和焦虑症状严重程度评分彼此显著相关，与强迫症症状严重程度显著相关，但与抽动严重程度无关。分析中出现了基于性别的差异。
在患有慢性抽动障碍的成年人中，焦虑症状比抑郁症状更为普遍和严重，共病的精神症状彼此之间的关联更为紧密，而与抽动严重程度的关联则不紧密，并且存在基于性别的差异。
