Grycz Mateusz, Janik Piotr
Department of Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland.
J Clin Med. 2024 Oct 4;13(19):5926. doi: 10.3390/jcm13195926.
: Behavioral disturbances are a common phenomenon associated with Gilles de la Tourette syndrome (GTS), which can manifest as non-obscene socially inappropriate behaviors (NOSIBs). The classification of NOSIB has not yet been clearly established. The objective of this study was to determine the frequency, age of onset, and clinical correlation of NOSIB with tic severity and the prevalence of comorbid psychiatric disorders in individuals with GTS. : A total of 365 participants (272 male, 74.5%) with GTS were included in the study. Of these, 278 (76.2%) were children and adolescents. The mean age of the participants at evaluation was 14.4 ± 9.8 years, with a range of 4 to 64 years. The clinical data of NOSIB were collected during a routine, ambulatory examination using half-structured questionnaires developed by the authors. : NOSIB was observed in 86 patients with GTS, representing a prevalence of 23.6%. NOSIB commenced at a mean age of 6.6 ± 4.1 years (range 2-19). The mean age at onset of NOSIB was 1.4 ± 3.7 years after the onset of tics, with 18 cases (26.1%) preceding tics and 13 cases (18.8%) starting at the same age as tics. The results of the multivariate analysis confirmed the associations between NOSIB and YGTSS ( = 0.02) and coprophenomena ( < 0.01), as well as ADHD ( < 0.01), ODD ( = 0.01), ASD ( < 0.01), and anxiety disorders ( = 0.02). : NOSIB is an early symptom of GTS that typically manifests in childhood and occurs in approximately a quarter of patients. Tic severity and the presence of psychiatric comorbidities, which indicate a more severe disease course, may serve as risk factors for NOSIB.
行为障碍是与抽动秽语综合征(GTS)相关的常见现象,可表现为非秽亵性社会不当行为(NOSIBs)。NOSIB的分类尚未明确确立。本研究的目的是确定NOSIB在GTS患者中的发生频率、发病年龄、与抽动严重程度的临床相关性以及共病精神障碍的患病率。
本研究共纳入365例GTS患者(272例男性,占74.5%)。其中,278例(76.2%)为儿童和青少年。评估时参与者的平均年龄为14.4±9.8岁,年龄范围为4至64岁。NOSIB的临床数据是在常规门诊检查期间,使用作者编制的半结构化问卷收集的。
在86例GTS患者中观察到NOSIB,患病率为23.6%。NOSIB开始的平均年龄为6.6±4.1岁(范围为2至19岁)。NOSIB发病的平均年龄比抽动开始晚1.4±3.7岁,18例(26.1%)在抽动之前出现,13例(18.8%)与抽动同时开始。多变量分析结果证实了NOSIB与耶鲁综合抽动严重程度量表(YGTSS)(P = 0.02)、伴发现象(P < 0.01)、注意缺陷多动障碍(ADHD)(P < 0.01)、对立违抗障碍(ODD)(P = 0.01)、孤独症谱系障碍(ASD)(P < 0.01)和焦虑症(P = 0.02)之间的关联。
NOSIB是GTS的一种早期症状,通常在儿童期出现,约四分之一的患者会发生。抽动严重程度和精神共病的存在表明疾病进程更严重,可能是NOSIB的危险因素。