Long-Term Follow-Up of Patients with Mass Social Media-Induced Illness Presenting with Functional Tic-like Behaviors

Only little is known about the prognosis of functional tic-like behaviors (FTLB), especially in the subgroup of patients with mass social media-induced illness (MSMI-FTLB).

To provide data of long-term follow-up (FU) of a carefully characterized group of patients with MSMI-FTLB to identify influencing factors such as treatment, exposure to social media, and comorbidities.

At FU (mean = 26.3 (range = 11-51) months after baseline), 30 patients (mean age = 22.5 years, n = 18 (60%) female) underwent an extensive semi-structured interview.

The majority of patients reported symptom improvement (n = 19, 63%) or complete remission (n = 7, 23%) of MSMI-FTLB, while only a minority reported no change (n = 4, 13%), and none worsening of symptoms. Factors associated with better prognosis were younger age, male sex, diagnosis early after disease onset, less lifetime psychiatric comorbidities, absence of depression, and discontinuation of secondary gain, while diagnostic acceptance or changes in daily social media time had no influence on prognosis. Of n = 26 patients (87%) receiving psychotherapy, n = 15 (58%) rated it as "helpful," but neither the presence of therapy nor the type of therapeutic approach was associated with significant differences in symptom improvement. At FU, n = 13 (43%) patients received medication, which most (n = 11, 85%) felt ineffective. N = 11 patients (36.7%) indicated that simply knowing the correct diagnosis was helpful in terms of symptom improvement.

In line with previous reports in FTLB, patients with MSMI-FTLB also have a good prognosis overall, especially in the case of younger age, male sex, early diagnosis, discontinuation of secondary gain, less psychiatric comorbidities, and absence of depression.