Neuropsychiatric comorbidities and associated factors in 182 Chinese children with tic disorders

Tic disorders (TD) often present with associated neuropsychiatric comorbidities. This study aims to examine the clinical manifestations of TD in pediatric patients and explore the spectrum and features of neuropsychiatric comorbidities among Chinese children diagnosed with TD.

A retrospective analysis was conducted on pediatric TD cases newly diagnosed at our institution, using the Mini International Neuropsychiatric Interview for Children and Adolescents 5.0 to screen for comorbidities. Furthermore, a statistical analysis of clinical features was undertaken.

The study enrolled 182 patients, comprising 140 males and 42 females. The diagnoses were distributed as follows: 65 cases of provisional TD, 29 cases of chronic TD, and 88 cases of Tourette syndrome. 94 (51.65%) patients presented with at least a single neuropsychiatric comorbid, while 40 (21.98%) patients exhibited two or more such comorbidities. TD is most frequently comorbid with attention-deficit hyperactivity disorder (33.52%, 61/182), oppositional defiant disorder (11.00%, 20/182) and current/previous manic/hypomanic episode (7.69%, 14/182). Children with comorbidities, compared to those without, experienced delayed diagnosis (P = 0.039), were more prone to developing vocal tics (simple vocal tics P = 0.030, complex vocal tics P < 0.001), lacked sibling companionship (P = 0.030), and exhibited more severe tics (P = 0.008). The prevalence of comorbidities was notably higher in children from single-parent households (93.3%) compared to those in two-parent families (P = 0.006). Individuals with multiple comorbidities had delayed diagnosis (P = 0.013), and notably experienced more triggering psychological factors such as pressure, anxiety, and anger. Sex, parents' educational backgrounds and severity of tics significantly related to specific comorbidity occurrence.

We identified several factors associated with comorbidities in children with TD, which aiding doctors in recognizing the comorbidities that require attention. Simultaneously, these factors help guide family members in providing targeted education that supports the physical and mental development of affected children.