Psychological network analysis of tic disorders in children and adolescents

Tic disorders (TD) is a common neurodevelopmental disorder in children and adolescents, often co-occurring with psychiatric comorbidities and significantly impairing functioning. Symptom network analysis can identify key nodes for targeted interventions.

Children and adolescents diagnosed with TD at Beijing Children's Hospital (May 2024-Feb 2025) were assessed using nine standardized scales covering tic symptoms and eight related psychological dimensions. Network analysis was applied to examine the symptom structure. Subgroup analyses were performed to compare network characteristics by gender and developmental stage.

715 TD patients were analyzed. In total sample, the tic symptoms (TIC) was directly linked to premonitory urges symptoms (PUT) and ADHD symptoms (ADH), and indirectly to depressive symptoms (DEP) and anxiety symptoms (ANX), with DEP as the central node (strength = 1.42). Centrality analysis highlighted DEP (strength = 1.42), neuroticism (NEU, strength = 1.27), and ANX (strength = 0.97) as key influencers. Gender-based analysis revealed stronger TIC-NSI (non-suicide self-injury, p = 0.020) and ANX-MPD (mobile-phone dependence, p = 0.041) connections in females. Developmental analysis revealed a stronger ADH-NEU link in children (p = 0.002), while TIC node (p = 0.024) and DEP node (p = 0.049) was more pronounced in adolescents.

TD symptoms were closely associated with premonitory urges and ADHD symptoms, while depressive symptoms, anxiety symptoms, and neuroticism emerged as central nodes in the network. These findings highlight the importance of comprehensive intervention strategies for achieving more sustained therapeutic outcomes in TD.