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Published Online: 24 April 2023

Dimensional Assessment of Depression and Anxiety in a Clinical Sample of Adults With Chronic Tic Disorder

Publication: The Journal of Neuropsychiatry and Clinical Neurosciences

Abstract

Objective:

Among adults with Tourette syndrome, depression and anxiety symptoms are widely prevalent and consistently associated with poor quality of life. Important knowledge gaps remain regarding mood and anxiety dimensions of the adult Tourette syndrome phenotype. Taking a dimensional approach, this study sought to determine the prevalence, severity, and clinical correlates of depression and anxiety symptoms in a clinical sample of adults with Tourette syndrome and other chronic tic disorders.

Methods:

A retrospective chart review was conducted of all adults with a chronic tic disorder presenting to a tertiary care Tourette syndrome clinic between December 2020 and July 2022. Information extracted during chart review included data from scales administered as part of routine care: Quality of Life in Neurological Disorders (Neuro-QoL) Depression Short Form, Neuro-QoL Anxiety Short Form, Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale, Dimensional Obsessive-Compulsive Scale, and Yale Global Tic Severity Scale. Relationships between variables were examined by conducting between-group, correlation, and multivariable regression analyses.

Results:

Data from 120 adult patients with a chronic tic disorder (77 men and 43 women) were analyzed. Neuro-QoL Anxiety scores were elevated in 66% of the cohort; Neuro-QoL Depression scores were elevated in 26%. Neuro-QoL Anxiety scores were significantly higher than general population norms, whereas Neuro-QoL Depression scores were not. After adjustment for covariates, depressive and anxiety symptom severity scores were significantly associated with each other and with obsessive-compulsive disorder symptom severity but not with tic severity. Sex-based differences emerged in the analyses.

Conclusions:

Among adults with chronic tic disorder, anxiety symptoms were more prevalent and severe than depressive symptoms, co-occurring psychiatric symptoms were more tightly linked with each other than with tic severity, and sex-based differences were evident.

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Supplementary Material

File (appi.neuropsych.20220197.ds001.pdf)

Information & Authors

Information

Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Pages: 352 - 360
PubMed: 37089074

History

Received: 15 November 2022
Revision received: 24 January 2023
Accepted: 2 February 2023
Published online: 24 April 2023
Published in print: Fall 2023

Keywords

  1. Chronic Tic Disorder
  2. Tourette Syndrome
  3. Depression
  4. Anxiety
  5. Neuropsychiatric Disorders
  6. Movement Disorder

Authors

Affiliations

David A. Isaacs, M.D., M.P.H. [email protected]
Department of Neurology, Vanderbilt University Medical Center, Nashville (Isaacs, Eckland); Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville (Isaacs); Department of Medicine, Health, and Society, Vanderbilt University, Nashville (Narapareddy); Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, and Department of Pediatric Neurology, Johns Hopkins Children’s Center, Baltimore (Riordan).
Ashruta Narapareddy
Department of Neurology, Vanderbilt University Medical Center, Nashville (Isaacs, Eckland); Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville (Isaacs); Department of Medicine, Health, and Society, Vanderbilt University, Nashville (Narapareddy); Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, and Department of Pediatric Neurology, Johns Hopkins Children’s Center, Baltimore (Riordan).
Michelle R. Eckland, B.S.
Department of Neurology, Vanderbilt University Medical Center, Nashville (Isaacs, Eckland); Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville (Isaacs); Department of Medicine, Health, and Society, Vanderbilt University, Nashville (Narapareddy); Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, and Department of Pediatric Neurology, Johns Hopkins Children’s Center, Baltimore (Riordan).
Heather R. Riordan, M.D.
Department of Neurology, Vanderbilt University Medical Center, Nashville (Isaacs, Eckland); Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville (Isaacs); Department of Medicine, Health, and Society, Vanderbilt University, Nashville (Narapareddy); Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, and Department of Pediatric Neurology, Johns Hopkins Children’s Center, Baltimore (Riordan).

Notes

Send correspondence to Dr. Isaacs ([email protected]).

Competing Interests

Dr. Isaacs has received grant funding from Teva Branded Pharmaceutical Products, Research and Development. Dr. Riordan has received an educational grant from Medtronic. The other authors report no financial relationships with commercial interests.

Funding Information

This work was supported by the Tourette Association of America (072720), the Vanderbilt Faculty Research Scholars Award, and the National Center for Advancing Translational Sciences (UL1-TR002243). The funders were not involved in study design; data collection, analysis, or interpretation; manuscript preparation; or decision to submit the article for publication.

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