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Aggressive symptoms in children with tic disorders.

Noa Benaroya-Milshtein1,2, Sharona Shmuel-Baruch3,4, Alan Apter3,5

  • 1The Matta and Harry Freund Neuropsychiatric Tourette Clinic, Department of Child and Adolescent Psychiatry, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. nbenaroya@gmail.com.

European Child & Adolescent Psychiatry
|August 10, 2019
PubMed
Summary

Aggressive behavior in children with tic disorders is not significantly different from healthy peers. However, attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) comorbidities increase aggression risk, with ADHD severity being a key predictor.

Keywords:
ADHDAggressionOCDOvert aggression scaleTicsTourette syndrome

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Area of Science:

  • Neuroscience
  • Child Psychiatry
  • Behavioral Science

Background:

  • Explosive anger and aggression are frequently reported in pediatric tic disorders, impacting quality of life.
  • The origins of aggression in tic disorder patients remain a subject of debate.

Purpose of the Study:

  • To investigate the relationship between tic disorders, their comorbidities, and aggressive behavior in children and adolescents.
  • To compare aggression levels in children with tic disorders to a healthy control group.

Main Methods:

  • A cohort of 47 children and adolescents (7-17 years) with Tourette syndrome or chronic tic disorders was assessed.
  • Psychopathology was evaluated using standardized scales for tics, OCD, ADHD, anxiety, and depression.
  • Aggression was measured using the Overt Aggression Scale and compared to 32 healthy controls.

Main Results:

  • No significant differences in overall aggression scores were found between children with tic disorders and controls.
  • Verbal aggression was the most common form, present in 70% of patients.
  • Aggression levels did not correlate with tic severity, but comorbid ADHD and OCD increased aggression probability.

Conclusions:

  • Aggressive behavior in children with tic disorders is not inherently different from healthy children without comorbidities.
  • Comorbid attention-deficit hyperactivity disorder (ADHD) is a significant predictor of aggression in pediatric tic disorders.
  • ADHD severity, rather than tic severity, appears to be the primary driver of aggressive behavior in this population.