Anxiety disorders and tic severity in juveniles with Tourette's disorder
Anxiety disorders and tic severity in juveniles with Tourette's disorder
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DOI：
10.1097/00004583-200005000-00009
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发表时间：
2000-05-01
影响因子：
13.3
通讯作者：
Kim, GS
中科院分区：
文献类型：
--
作者：
Coffey, BJ;Biederman, J;Kim, GS
目的：假设抽动障碍(TD)青少年抽动障碍的严重程度与焦虑症的共病有关。方法：受试者为190名符合DSM-III-R诊断标准的青少年，他们在1994-1997年间连续被转诊到儿科精神药理学项目。受试者最初通过临床访谈和学龄儿童情感障碍和精神分裂症量表-流行病学版进行评估。统计分析采用t检验、X(2)检验和Logistic回归分析。结果：轻、中度TD患者134例，重度TD患者56例。两组患者在社会经济地位、性别分布、TD发病年龄等方面均无显著差异。两组不能通过存在共病情绪或包括注意力缺陷多动障碍在内的破坏性行为障碍来区分。虽然强迫症(OCD)在重度SD患者中的比例过高，但差异未达到统计学意义。排除社交恐惧症和简单恐惧症，所有其他焦虑症在患有严重TD的受试者中表现得更明显；分离焦虑症最能预测抽动的严重程度，无论是否存在强迫症或其他焦虑症。结论：非强迫症焦虑症，尤其是分离焦虑症可能与TD患者抽动的严重程度显著相关。
Objective: It was hypothesized that comorbidity with anxiety disorders would predict tic severity in youths with Tourette's disorder (TD). Method: Subjects were 190 youths meeting DSM-III-R diagnostic criteria for TD who were consecutively referred to a pediatric psychopharmacology program between 1994 and 1997. Subjects were initially evaluated with a clinical interview and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version. Statistical analysis used t tests, chi(2) tests, and logistic regression analysis. Results: One hundred thirty-four subjects were classified as mild/moderate and 56 as severe TD cases. No meaningful differences were found in socioeconomic status, gender distribution, or age at onset of TD between the 2 groups. The 2 groups could not be differentiated by the presence of comorbid mood or disruptive behavior disorders including attention-deficit hyperactivity disorder. Although obsessive-compulsive disorder (OCD) was overrepresented among the severe SD cases, the difference failed to reach statistical significance. Excluding social and simple phobias, all other anxiety disorders were more clearly overrepresented among subjects with severe TD; separation anxiety disorder most robustly predicted tic severity, irrespective of the presence of OCD or other anxiety disorders. Conclusion: Findings suggest that non-OCD anxiety disorders in general and separation anxiety disorder in particular may be significantly associated with tic severity in referred TD patients.