Distinguishing illness severity from tic severity in children and adolescents with Tourette's disorder
Department of Psychiatry
Medical Subject Headings
Adolescent; Adult; Anxiety Disorders; Bipolar Disorder; Child; Child, Preschool; Depressive Disorder, Major; Female; Humans; Male; Obsessive-Compulsive Disorder; Patient Admission; Predictive Value of Tests; Psychiatric Status Rating Scales; Psychometrics; Severity of Illness Index; Tics; Tourette Syndrome
OBJECTIVE: To examine whether tic severity, comorbid disorders, or both are associated with illness morbidity in youths with Tourette's disorder (TD).
METHOD: Subjects were 156 consecutively referred youths (aged 5-20 years) who met DSM-III-R criteria for Tourette's disorder at a major academic medical center. All subjects were evaluated with a clinical interview by a child and adolescent psychiatrist and an assessment battery that included the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version. Statistical analysis used chi 2 and multivariate logistic regression.
RESULTS: Nineteen (12%) of the 156 youths with TD required psychiatric hospitalization. Current age, TD severity, TD duration, obsessive-compulsive disorder, psychosis, major depression, bipolar disorder, panic disorder, and overanxious disorder were significant univariate predictors of psychiatric hospitalization (p < .01). While tic severity was marginally significant as a predictor of psychiatric hospitalization (p < .05), major depression (p < .016) and bipolar disorder (p < .001) were robust predictors of psychiatric hospitalization, even after statistical adjustment for collinearity and correction for all other variables assessed.
CONCLUSION: The findings indicate that comorbid mood disorders are strongly associated with illness morbidity in youths with TD, highlighting the importance of attention to comorbidity in patients with TD.
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Citation: J Am Acad Child Adolesc Psychiatry. 2000 May;39(5):556-61. Link to article on publisher's site
Coffey, Barbara J.; Biederman, Joseph; Geller, Daniel A.; Spencer, Thomas J.; Kim, Grace S.; Bellordre, Christine A.; Frazier, Jean A.; Cradock, Kathleen; and Magovcevic, Mariola, "Distinguishing illness severity from tic severity in children and adolescents with Tourette's disorder" (2000). Psychiatry Publications and Presentations. 383.