Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome.
Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome.
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DOI：
10.1001/archpedi.160.1.65
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发表时间：
2006-01-01
影响因子：
--
通讯作者：
Leckman, James F
中科院分区：
文献类型：
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作者：
Bloch, Michael H;Peterson, Bradley S;Leckman, James F
背景：抽动秽语综合症（TS）是一种儿童期发病的神经精神疾病，其特征是运动抽动和发音抽动。二分之一到三分之二的 TS 儿童在青春期期间抽动症状会减轻或完全消失。至少三分之一的 TS 成人患有强迫症 (OCD)。 目的： 阐明 TS 儿童抽动症和强迫症症状的临床病程，并确定儿童时期的基线临床测量是否与青春期后期和成年早期的未来症状严重程度相关。 设计： 前瞻性队列研究。 地点： 耶鲁儿童研究中心抽动症和强迫症门诊专业 诊所。参与者：46 名 TS 儿童在 14 岁之前接受了结构化临床评估。主要结果指标：专家在平均 7.6 年后（范围 3.8-12.8 年）的随访访谈中评估抽动和强迫症症状的严重程度。结果：85% 的受试者报告青春期抽动症状减轻。只有儿童时期抽动严重程度的增加与随访时抽动严重程度的增加相关。抽动最严重的平均年龄为 10.6 岁。百分之四十一的 TS 患者报告曾至少经历过中度强迫症症状。最严重的强迫症症状比最严重的抽动症状晚大约两年。儿童智商的提高与随访时强迫症严重程度的增加密切相关。结论：患有 TS 的儿童的强迫症症状在年龄较大时变得更加严重，并且比抽动症状更有可能持续存在。
BACKGROUND: Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder that is characterized by both motor and phonic tics. One half to two thirds of children with TS experience a reduction or complete resolution of tic symptoms during adolescence. At least one third of adults with TS have comorbid obsessive-compulsive disorder (OCD).OBJECTIVES: To clarify the clinical course of tic and OCD symptoms in children with TS and determine if baseline clinical measurements in childhood are associated with future symptom severity in late adolescence and early adulthood.DESIGN: Prospective cohort study.SETTING: Yale Child Study Center tic and OCD outpatient specialty clinic.PARTICIPANTS: Forty-six children with TS who received a structured clinical evaluation prior to age 14 years.MAIN OUTCOME MEASURES: Expert-rated tic and OCD symptom severity at follow-up interview an average of 7.6 years later (range, 3.8-12.8 years).RESULTS: Eighty-five percent of subjects reported a reduction in tic symptoms during adolescence. Only increased tic severity in childhood was associated with increased tic severity at follow-up. The average age at worst-ever tic severity was 10.6 years. Forty-one percent of patients with TS reported at one time experiencing at least moderate OCD symptoms. Worst-ever OCD symptoms occurred approximately 2 years later than worst-ever tic symptoms. Increased childhood IQ was strongly associated with increased OCD severity at follow-up.CONCLUSION: Obsessive-compulsive disorder symptoms in children with TS became more severe at a later age and were more likely to persist than tic symptoms.