The effects of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children: a cross-sectional study
The effects of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children: a cross-sectional study
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DOI：
10.1186/s13034-019-0290-3
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发表时间：
2019-06-28
影响因子：
5.6
通讯作者：
Kano, Yukiko
中科院分区：
文献类型：
--
作者：
Goto, Ryunosuke;Fujio, Miyuki;Kano, Yukiko
背景资料：许多4至6岁的儿童表现出强迫样行为，通常伴有伴发的抽动秽语症状，这使得这个年龄组对于研究伴发抽动秽语症状与强迫样行为的影响至关重要。然而，这些影响尚未阐明：目前还不清楚是否有强迫样行为共病抽搐导致生活质量下降。本横断面研究的目的是探讨强迫样行为在非常年幼的children. Methods：自我管理的问卷调查共病的抽动秽语症状的影响所造成的痛苦，被分发到监护人的儿童年龄在4至6岁参加任何的59个公立幼儿园在一定的病房在日本东京。问卷包含关于Tourette症状的存在、特定运动和发声抽搐的存在、强迫样行为的频率/强度以及由强迫样行为引起的痛苦的问题，其在1至5的量表上评定。此外，问卷中还包括自闭症谱系障碍（ASD）特征、注意力缺陷/多动障碍（ADHD）特征、内化行为特征和外化行为特征等问题，作为强迫样行为引起的痛苦的可能混杂因素。采用Wilcoxon秩和检验比较Tourette症状组和非Tourette症状组儿童的强迫样行为和强迫样行为频率/强度所造成的痛苦。此外，进行逐步回归分析，以评估独立变量对强迫样行为引起的痛苦的影响。另一个逐步回归分析，以评估之间的关系所造成的痛苦，强迫样行为和存在五个特定的运动和声乐tics.Results：在675个合格的参与者，痛苦，由于强迫样行为是显着较高的儿童在抽动秽语症状组相比，非抽动秽语症状组（2.00比1.00，P <0.001）。逐步回归分析表明，频率/强度的强迫样行为，在抽动秽语综合征的症状组，自闭症谱系障碍的特点，和内化的行为特征是由于强迫样行为的困扰的预测因子。两个具体的抽搐，重复的噪音和声音和重复的颈部，肩部，或躯干运动，是显着的预测压力，由于强制性的行为。结论：共病的抽动秽语症状可能会恶化的困扰所造成的强迫性的行为在4至6岁的儿童，和特定的运动和声乐抽搐可能会导致更大的困扰。
Background: Many children 4 to 6 years old exhibit compulsive-like behavior, often with comorbid Tourette symptoms, making this age group critical for investigating the effects of having comorbid Tourette symptoms with compulsive-like behavior. However, these effects have not yet been elucidated: it is unclear whether having comorbid tics with compulsive-like behavior leads to lower quality of life. This cross-sectional study aims to investigate the effect of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children.Methods: Self-administered questionnaires were distributed to guardians of children aged 4 to 6 attending any of the 59 public preschools in a certain ward in Tokyo, Japan. The questionnaire contained questions on the presence of Tourette symptoms, the presence of specific motor and vocal tics, frequency/intensity of compulsive-like behavior, and the distress caused by compulsive-like behavior, which was rated on a scale of 1 to 5. Additionally, questions on autism spectrum disorder (ASD) traits, attention-deficit/hyperactivity disorder (ADHD) traits, internalizing behavior traits, and externalizing behavior traits were included in the questionnaire as possible confounders of distress caused by compulsive-like behavior. Wilcoxon rank-sum tests were conducted to compare the distress caused by compulsive-like behavior and frequency/intensity of compulsive-like behavior between children in the Tourette symptoms group and the non-Tourette symptoms group. Furthermore, a stepwise regression analysis was performed to assess the effects of the independent variables on distress caused by compulsive-like behavior. Another stepwise regression analysis was performed to assess the relationship between distress caused by compulsive-like behavior and the presence of five specific motor and vocal tics.Results: Of the 675 eligible participants, distress due to compulsive-like behavior was significantly higher in children in the Tourette symptoms group compared to the non-Tourette symptoms group (2.00 vs 1.00, P < 0.001). Stepwise regression analysis showed that frequency/intensity of compulsive-like behavior, being in the Tourette symptoms group, ASD traits, and internalizing behavior traits were predictors of distress due to compulsive-like behavior. Two specific tics, repetitive noises and sounds and repetitive neck, shoulder, or trunk movements, were significant predictors of distress due to compulsive-like behavior.Conclusions: Comorbid Tourette symptoms may worsen distress caused by compulsive-like behavior in children 4 to 6 years old, and specific motor and vocal tics may lead to greater distress.