Self-esteem in adults with Tourette syndrome and chronic tic disorders: The roles of tic severity, treatment, and comorbidity.
Self-esteem in adults with Tourette syndrome and chronic tic disorders: The roles of tic severity, treatment, and comorbidity.
复制标题
抽动秽语综合征和慢性抽动障碍成人的自尊：抽动严重程度、治疗和合并症的作用。
DOI：
10.1016/j.comppsych.2018.04.008
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发表时间：
2018
影响因子：
7.3
通讯作者：
Wilhelm,Sabine
中科院分区：
文献类型：
--
作者：
Weingarden,Hilary;Scahill,Lawrence;Hoeppner,Susanne;Peterson,AlanL;Woods,DouglasW;Walkup,JohnT;Piacentini,John;Wilhelm,Sabine
背景抽动秽语综合症（TS）和慢性抽动障碍（CTD）是可能严重影响自尊的耻辱性疾病。另外，共病精神疾病可能比抽动本身更能影响自尊。现有关于 TS/CTD 自尊的研究有限，并不一致地检验了合并症对自尊的影响，并得出了不同的结果。方法本研究旨在澄清抽动与合并症诊断对自尊的作用，在一个大的、仔细诊断的成人 TS/CTD 样本中（N = 122）接受 10 周的抽动综合行为干预（CBIT）或 心理教育和支持治疗 (PST)。结果仅患有 TS/CTD 的成年人与正常患有 TS/CTD 的成年人之间的基线自尊没有差异，而患有 TS/CTD 并伴有精神疾病的成年人的自尊显着较低。在多元回归测试中，抽动严重程度、共存精神疾病和抑郁严重程度与自尊之间的基线关联，共病和抑郁严重程度与自尊显着相关，而抽动严重程度则不然。最后，使用广义线性模型，我们测试了治疗分配、合并症及其相互作用对整个治疗过程中自尊变化的影响，并控制了基线抑郁严重程度。结果显示，对于那些患有合并症的人来说，CBIT 比 PST 更能显着提高自尊。结论 对于患有 TS/CTD 的成人来说，合并症疾病似乎比抽动更能影响自尊。治疗 TS/CTD 时，应注意治疗伴随抽动的合并症诊断。
BackgroundTourette syndrome (TS) and chronic tic disorders (CTD) are stigmatizing disorders that may significantly impact self-esteem. Alternatively, comorbid psychiatric illnesses may affect self-esteem more than tics themselves. Extant research on self-esteem in TS/CTD is limited, has inconsistently examined the effect of comorbidities on self-esteem, and yields mixed findings.MethodThis study aimed to clarify the roles of tics versus comorbid diagnoses on self-esteem in a large, carefully diagnosed sample of adults with TS/CTD (N= 122) receiving 10 weeks of Comprehensive Behavioral Intervention for Tics (CBIT) or Psychoeducation and Supportive Therapy (PST).ResultsBaseline self-esteem did not differ between adults with TS/CTD only and normative means, whereas self-esteem was significantly lower among adults with TS/CTD with a comorbid psychiatric illness. In a multiple regression testing the baseline association between tic severity, presence of comorbid psychiatric illness, and depression severity with self-esteem, comorbidity and depression severity were significantly associated with self-esteem, whereas tic severity was not. Finally, using a generalized linear model, we tested the effects of treatment assignment, comorbidity, and their interaction on changes in self-esteem across treatment, controlling for baseline depression severity. Results showed that for those with a comorbid illness, self-esteem improved significantly more with CBIT than with PST.ConclusionsComorbid illnesses appear to affect self-esteem more so than tics among adults with TS/CTD. Therapeutic attention should be paid to treating comorbid diagnoses alongside tics when treating TS/CTD.