Suicidal Thoughts and Behaviors in Children and Adolescents With Chronic Tic Disorders

Storch, Eric A.; Hanks, Camille E.; Mink, Jonathan W.; McGuire, Joseph F.; Adams, Heather; Augustine, Erika F.; Vierhile, Amy; Thatcher, Alyssa; Bitsko, Rebecca H.; Lewin, Adam B.; Murphy, Tanya K.

doi:10.1002/da.22357

Cited by 50 publications

(37 citation statements)

References 57 publications

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“…Finally, suicidality (thoughts/ideation or behaviours including deliberate self-harm), is an important but relatively neglected aspect of GTS research with studies showing a higher prevalence in GTS (9.7%) when compared to healthy controls (3%) 131 . …”

Section: Shared Genetic Basis With Other Neuropsychiatric and Neurolomentioning

confidence: 99%

Gilles de la Tourette syndrome

Robertson

Eapen

Singer

et al. 2017

Nat Rev Dis Primers

296

244

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The unstructured abstract of 200 words maximum should summarize the main points of the article. All information mentioned in the abstract must be addressed somewhere in the main article. The abstract should not contain references or display item citations. Gilles de la Tourette Syndrome (GTS), a reasonably common disorder, has had a long, tortuous and somewhat controversial history. First and well described in the 18th century 1,2 , the main features of GTS have, however, remained fairly constant. The core diagnostic features are multiple motor and one or more vocal (phonic) tics lasting for over a year. In addition, almost pathognomic, but not necessary, features described in the early documentations include coprolalia (involuntary, inappropriate swearing), and echophenomena (copying behaviours), as well as many co-morbidities and psychopathologies 3 . Introduction [suggested 500 words, is 544 words -8 refs] Mary Robertson Thoughts for Mary -Your word count when combining sections 1 and 2 is 1001 (1000 limit)-so OKGTS was originally described in France and the majority of early literature came from and standardised schedules such as diagnostic confidence, measurement of severity, QoL, and assessment of both co-morbidities and co-existent psychopathologies are currently available.Large international collaborative consortia are engaged in studies exploring aetiological factors in particular, and some international treatment studies are also underway. Perhaps as a result of earlier small patient numbers, the treatment trials have given good clues to management, but unsurprisingly systematic reviews and meta-analyses have been hampered, giving disappointing, if not unexpected, results. Intriguingly medications from the typical NRDP -Gilles de la Tourette Syndrome 3 antipsychotic family including haloperidol, which first had documented success in 1961 6,7 are still being used, although successive generations of "atypicals" are currently more in vogue,as are medications such as alpha-2-adrenergic agonists. Interestingly, haloperidol remains the only medication prescribed on licence in many parts of the world. In contrast to disorders such as ADHD, in which it is clear which treatments work and which do not require further study 8 , a variety of treatment studies in GTS are still being undertaken, including using other medications (trying to improve efficacy and reduce side effects), behavioural therapies, deep brain stimulation (for refractory cases), and other more "alternative" methods such as "orthotics" (teeth braces). The GTS community has to first agree on how common GTS is and then seek funding for research in the areas of major importance.2. Epidemiology [suggested 500 words, is 444 words, 6 additional refs] Mary Robertson GTS was for many years thought to be not only very rare, but a bizarre curiosity, with sporadic case reports peppering the literature. The belief that GTS was uncommon at the very least was held by many until Comings 9 controversially suggested that GTS occurred in between 0.66% and...

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Section: Shared Genetic Basis With Other Neuropsychiatric and Neurolomentioning

confidence: 99%

Gilles de la Tourette syndrome

Robertson

Eapen

Singer

et al. 2017

Nat Rev Dis Primers

296

244

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confidence: 94%

“…In the only study of SI in children and adolescents with TD to date, around 10% of children had experienced SI over the past year, significantly higher than rates endorsed by community controls (Storch et al, 2015a). Suicidal ideation was associated with higher tic severity, impairment, depressive symptoms, anxiety symptoms, hyperactivity/impulsivity, and oppositional behaviors (Storch et al, 2015a). Importantly, anxiety and depressive symptoms (collectively) fully mediated the relationship between tic severity and SI, theoretically suggesting that it is the presence of these symptoms that increases youth risk rather than their TD per se.…”

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confidence: 94%

“…Firstly, this study aimed to examine the incidence of suicidal ideation in treatment-seeking youth with TD, and to examine the agreement between parent and child reports. We expected that, similar to Storch et al (2015a), around 10% of youth with TD would experience SI as endorsed by either parent or child report. Given existing findings suggesting limitations to parental insight into these symptoms (e.g., Achenbach, 2011; Breton et al, 2002; Klaus et al, 2009; Walker et al, 1990), we anticipated higher rates of SI to be endorsed by youth than their parents.…”

mentioning

confidence: 99%

“…We hypothesized that SI would be positively associated with tic severity, anxiety symptoms, depressive symptoms, and affective lability, and negatively associated with distress tolerance and global functioning. Third, we aimed to extend the model proposed by Storch et al (2015a) to examine whether tics impacted SI by increasing anxiety, depressive and/or externalizing symptoms. Our hypothesis was that that tics would have no direct impact on SI, but would indirectly influence SI severity by increasing anxiety, depressive and externalizing symptoms.…”

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confidence: 99%

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Suicidal ideation in youth with tic disorders

Johnco

McGuire

McBride

et al. 2016

Journal of Affective Disorders

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Background This study examined the incidence and clinical correlates of suicidal ideation (SI) in youth with tic disorders (TD). The independent contribution of tics, anxiety, depressive and externalizing symptoms on SI severity in youth with TD was assessed. Method Participants were 75 treatment-seeking youth with a TD (N = 75) aged 6–18. Participants completed diagnostic assessments, clinician-ratings, self- and parent-report measures of emotional functioning and the presence and/or severity of suicidal ideation. Results Based on youth-report, 61% of youth endorsed at least some symptoms of SI, and 8% endorsed symptoms that exceeded the clinically significant cut-off. Parents reported SI in 11% of cases, with generally poor agreement between parent- and youth-report. Suicidal ideation correlated with higher anxiety, depressive and externalizing symptoms, affective lability, and with poorer distress tolerance and overall functioning. Anxiety, depressive and externalizing symptoms showed an independent relationship with SI. Tic severity was not associated with SI. Rather, higher tic severity was associated with an increase in anxiety symptoms, which in turn, was associated with greater SI severity. Limitations Cross-sectional data limits causal conclusions. Diagnosis was based on unstructured assessments by expert clinicians, including consensus diagnosis, rather than structured clinical interviews. Conclusions Around 8–11% of youth with TD experienced SI. Tic severity did not have any direct influence on SI, however the presence of comorbid anxiety and depressive symptoms significantly increases this risk. Results suggest that it is psychiatric comorbidity, rather than tics themselves, that predispose youth with tic disorders to increased risk of suicidality.

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