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The effects of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children: a

Ryunosuke Goto¹, Miyuki Fujio², Natsumi Matsuda³

¹1The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan.

Child and Adolescent Psychiatry and Mental Health

|July 13, 2019

Insights

Children with Tourette symptoms experience greater distress from compulsive behaviors. Specific tics, like repetitive noises and movements, significantly increase this distress in young children.

Area of Science:

Child psychology
Neurodevelopmental disorders
Behavioral science

Background:

Compulsive-like behaviors are common in 4-6 year olds.
Comorbid Tourette symptoms in this age group are understudied.
The impact of Tourette symptoms on quality of life in children with compulsive behaviors is unclear.

Purpose of the Study:

To investigate the effect of comorbid Tourette symptoms on distress caused by compulsive-like behavior in young children.
To determine if Tourette symptoms exacerbate distress in children with compulsive behaviors.
To identify specific tics associated with increased distress.

Main Methods:

Cross-sectional study of 675 children aged 4-6 in Tokyo preschools.
Guardian-reported questionnaires assessed Tourette symptoms, tics, compulsive behavior frequency/intensity, and distress.
Statistical analyses included Wilcoxon rank-sum tests and stepwise regression.

Main Results:

Children with Tourette symptoms reported significantly higher distress from compulsive behaviors (2.00 vs 1.00, P < 0.001).
Predictors of distress included compulsive behavior frequency/intensity, Tourette symptoms, autism spectrum disorder (ASD) traits, and internalizing behaviors.
Repetitive noises/sounds and neck/shoulder/trunk movements were significant predictors of distress.

Conclusions:

Comorbid Tourette symptoms appear to worsen distress associated with compulsive-like behavior in young children.
Specific motor and vocal tics are linked to increased distress in this population.
Findings highlight the importance of addressing comorbid conditions in pediatric behavioral health.

Read full analysis

Abstract

Background:

Many children 4 to 6 years old exhibit compulsive-like behavior, often with comorbid Tourette symptoms, making this age group critical for investigating the effects of having comorbid Tourette symptoms with compulsive-like behavior. However, these effects have not yet been elucidated: it is unclear whether having comorbid tics with compulsive-like behavior leads to lower quality of life. This cross-sectional study aims to investigate the effect of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children.

Methods:

Self-administered questionnaires were distributed to guardians of children aged 4 to 6 attending any of the 59 public preschools in a certain ward in Tokyo, Japan. The questionnaire contained questions on the presence of Tourette symptoms, the presence of specific motor and vocal tics, frequency/intensity of compulsive-like behavior, and the distress caused by compulsive-like behavior, which was rated on a scale of 1 to 5. Additionally, questions on autism spectrum disorder (ASD) traits, attention-deficit/hyperactivity disorder (ADHD) traits, internalizing behavior traits, and externalizing behavior traits were included in the questionnaire as possible confounders of distress caused by compulsive-like behavior. Wilcoxon rank-sum tests were conducted to compare the distress caused by compulsive-like behavior and frequency/intensity of compulsive-like behavior between children in the Tourette symptoms group and the non-Tourette symptoms group. Furthermore, a stepwise regression analysis was performed to assess the effects of the independent variables on distress caused by compulsive-like behavior. Another stepwise regression analysis was performed to assess the relationship between distress caused by compulsive-like behavior and the presence of five specific motor and vocal tics.

Results:

Of the 675 eligible participants, distress due to compulsive-like behavior was significantly higher in children in the Tourette symptoms group compared to the non-Tourette symptoms group (2.00 vs 1.00, P < 0.001). Stepwise regression analysis showed that frequency/intensity of compulsive-like behavior, being in the Tourette symptoms group, ASD traits, and internalizing behavior traits were predictors of distress due to compulsive-like behavior. Two specific tics, repetitive noises and sounds and repetitive neck, shoulder, or trunk movements, were significant predictors of distress due to compulsive-like behavior.

Conclusions:

Comorbid Tourette symptoms may worsen distress caused by compulsive-like behavior in children 4 to 6 years old, and specific motor and vocal tics may lead to greater distress.

Keywords:

Comorbidity Compulsive-like behavior Distress Preschool children Tics Tourette’s disorder

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