| Purpose:1.Through a cross-sectional survey,comprehensively understand the adult prognosis of children with tic disorder,as well as the education level,employment status,characteristics of tic symptoms,comorbidities,treatment,and related factors of inducing or aggravating symptoms of adults with tic disorder.2.Through a retrospective survey of the adult included subjects,to clarify the exposure of juvenile-related factors,and to explore the risk factors related to adult prognosis,in order to guide the clinical treatment of juvenile tic disorder.Method:The cases collected in this project are all from outpatients of Dr.HAN Fei,Department of Pediatrics,Guang’anmen Hospital,Chinese Academy of Chinese Medical Sciences.Select patients with tic disorders whose initial visit time was from 2010-1-1 to 2019-12-31 and reached the age of 18 by 2020-12-31.Using the retrospective case-control research method,combined with clinical and literature research,we compiled a "Clinical Case Follow-up Form"(including two parts with tics in adults and those without tic symptoms in adults),and entered it into the"Questionnaire Star" applet An online return visit form was made,and the questionnaire was filled in and collected data by telephone return visit.The patients who still had symptoms in adulthood were taken as the case group,and those who had no symptoms after adulthood were taken as the control group,and the related exposure factors in childhood were compared between the two groups,including gender,age at the onset of tic disorder,family history,duration of traditional Chinese medicine treatment,and initial diagnosis.There were 11 risk factors,including vocal tics,Yale scale score at the first visit,comorbidities,treatment results in childhood,recurrent respiratory inflammation in childhood,family education style,and irritability and irritability of parents.The risk factors affecting the adult prognosis of children with TD were obtained.At the same time,the education level,employment situation,characteristics of tic symptoms,comorbidities,treatment,and related factors of inducing or exacerbating symptoms of patients with symptoms after adulthood were investigated to comprehensively understand the clinical characteristics of adult TD patients.Result:1.A total of 534 cases were finally included in the study,including 262 cases in the case group,217 males and 45 females,with a male-female ratio of 4.84:1;272 cases in the control group,with 230 males and 42 females,with a male-to-female ratio of 5.48:1.The age of the case group was between 20 and 27 years old,with an average age of 21.62.the age of the control group was between 20 and 26 years old,with an average age of 21.48.2.Among the 534 subjects,272 had no symptoms in adulthood,accounting for 50.94%.262 cases still showed tic symptoms in adulthood,accounting for 49.06%;210 cases had symptoms that were relieved while compared with childhood,accounting for 39.33%(534),80.15%(262);17 cases showed similar symptoms to those in childhood,accounting for 3.18%(534),6.49%(262);2 cases had symptoms that were worse than those in childhood,accounting for 0.37%(534),0.76%(262);33 cases of adult recurrence,accounting for 6.18%(534),12.60(262).3.Among the 262 adult patients,159 cases showed facial tics,accounting for 60.69%;followed by vocal tics,110 cases showed vocal tics,accounting for 41.98%;82 cases showed head,neck and shoulder tics,accounting for 31.3%%;64 cases showed tics of trunk and limbs,accounting for 24.43%;17 cases showed complex tics,accounting for 6.49%.According to the Yale scale,244 cases were mild,accounting for 93.13%;15 cases were moderate,accounting for 5.73%;3 cases were severe,accounting for 1.15%.4.After single factor screening,family history,duration of traditional Chinese medicine treatment(years),vocal tics,Yale scale score,comorbidities,symptoms at the time of drug withdrawal,repeated respiratory tract inflammation,family education methods,and parental personality were 9 items.Factors were correlated with symptoms in adulthood(P<0.05).The above 9 factors were included in multivariate analysis,and the results showed that family history OR(95%CI)=3.54(1.40-8.96),P=0.008;Yale scale score OR(95%CI)=2.91(1.79-4.75),P<0.001;childhood treatment outcome OR(95%CI)=20.35(12.30-33.68),P<0.001;repeated airway inflammation OR(95%CI)=2.34(1.41-3.86),P=0.001;parental personality OR(95%CI)=3.13(1.74-5.64),P<0.001.It suggests that family history,initial Yale scale score,treatment outcome in childhood,recurrent respiratory tract inflammation,parental personality are related to tic symptoms in adulthood.Conclusion:1.Family history,initial Yale scale score,treatment outcome in childhood,recurrent respiratory tract inflammation,parental personality are related to tic symptoms in adulthood.2.After a certain treatment in childhood,the adult prognosis of most patients is relatively good,and some patients’ symptoms can be significantly relieved after puberty.3.The tic manifestations of adult patients with tic disorders are basically the continuation of the tic symptoms in childhood.4.A considerable number of adult patients reported that their emotions were more nervous and prone to anxiety than their peers.The emotional problems of adult TD patients are still worthy of attention.5.Clinical guidance for juvenile tic disorder:pay attention to the treatment of TD children with family history of tic disorder,severe illness,repeated respiratory tract inflammation,or parents who are irritable and irritable;put emphasis on the emotional counseling of the mother of the child,the treatment of respiratory tract inflammation treatment and the results of juvenile treatment.Understanding the symptoms left by incomplete treatment in juvenile can still be delayed into adulthood. |
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