Clinical Study Of Adult Tic Disorder

Objective:Tic Disorder (TD) is a multifaceted neurobehavioral disorder consisting most notably of motor or phonic tics, often accompanied by a variety of behavioral comorbidities including attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD).Most tic disorder start before age18years, and therefore most studies have focused on childhood TS, whereas the disorder in adults has not been well characterized. The objective of this study is to explore the tic characteristics of TD in the adult population and how the comorbidity OCD affect the disease.Method:We collected relevant clinical data including age, age at onset, gender, tic characteristics and family history of neurologic and other medical problems. In addition, we collected information on comorbidities, including OCD, anxiety disorder and and depression disorder. And all the patients recruited were required to complete the YGTSS, YBOCS, BDI, BAI and QOL-BREF. Patients were divided into two groups depending on with or without OCD. TD-only group were compared to TD+OCD group using standardised measures of tic severity, depression, anxiety and quality of life. All the data analyses were performed using IBM SPSS version19.0. Frequencies and percentages were used for categorical data. Student’s t test was used for variables with continuous data. Chi-square test was used to compare cohorts.Results:In study part1we included45adults who met our criteria for inclusion into the study. The mean age at visit of45adult TS patients was27.73±8.64years. The mean age at onset was17.04±10.76years. There were33men and12women. Of all the adult TS patients,31(68.89%) had a history of tics with onset before the age of18years, with14(31.11%) reporting first occurrence of tics after the age of18years. Seventeen(37.78%) patients had isolated motor tics,28(62.22%) patients had motor and vocal tics.Thirty-seven (82.20%) patients had a premonitory sensory symptom before the tics. In studypart236patients were recruited. Thirty-four patients had expierenced obsessive-compulsive symptoms. Twenty patients meet the critiea of OCD. All the patients were then divided into two groups with16patients in TD-only group and20patients in TD+OCD group. Adults with comorbid OCD had significantly more severe tics when compared with those without OCD.The YGTSS score for TD-only group and TD+OCD group were14.69±5.17and19.60±7.79separately (P<0.05). TD+OCD patients had significantly more depression and anxiety symptoms than patients with TD-only.And the TD-only group had a higher QOL scores than TD+OCD group.Conclusion:Tic disorders in adults have its own characteristics. TD with OCD is a more severe subtype of TD than TD without OCD.Adults with comorbid OCD had significantly more severe tics when compared with those without OCD. TD+OCD patients had significantly more depression and anxiety symptoms than patients with TD-only. And the comorbid OCDwould affect patients’ life quality.