Araştırma Makalesi
BibTex RIS Kaynak Göster

Çocukluk çağı tik bozukluklarının sosyodemografik ve klinik özellikleri

Yıl 2019, Cilt: 44 Sayı: Ek 1, 251 - 262, 29.12.2019
https://doi.org/10.17826/cumj.628103

Öz

Amaç: Bu çalışmada, tik bozukluğu tanısı alan çocuk ve ergenlerin sosyodemografik verileri, klinik özellikleri ve eşlik eden diğer ruhsal bozuklukların araştırılması amaçlanmıştır. 

Gereç ve Yöntem: Çalışmaya, Tik Bozukluğu tanısı olan 4-18 yaş aralığında 187 olgu alındı. Ruhsal belirtilerin taranması amacı ile Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam boyu Şekli Türkçe uyarlaması ÇDŞG-ŞY (K-SADS-PL), Tik belirti şiddeti için, Yale Genel Tik Ağırlığını Derecelendirme Ölçeği (YGTDÖ) kullanıldı. Olguların demografik bilgileri ve ailesel hastalık öyküleri kaydedildi. 

Bulgular: Çalışmaya, ortalama yaşı 10,9±2,6 yaş olan, 37 kız (ortalama 10,9±2,5 yaş) ve 150 erkek (ortalama 10,9±2,7 yaş) olgu alındı. Tik Bozukluğu alt tipine göre olguların 135’i (%72,2) Tourette Sendromu, %26,7’si (n=50) motor tik bozukluğu, 2’si (%1,1) bunların dışında bir tik bozukluğu tanısı aldı. Tik Bozukluğu alt tipine göre olguların ortalama yaşı, ilk belirti yaşı açısından iki grup arasında anlamlı fark yoktu. Olguların % 91’inde tiklerin başlangıç yaşı, 12 yaş ve altında idi.  Kızlara göre erkekler arasında en az bir eş tanıya sahip olma oranı, ortalama eş tanı sayısı ve dikkat eksikliği hiperaktivite bozukluğu (DEHB) eş tanı oranı anlamlı biçimde daha fazlaydı. En sık görülen eş tanılar, DEHB (n=142, %75,9), obsesif kompulsif bozukluk (OKB) (n=108, %57,8) ve anksiyete bozukluğu (n=57, %30,4) idi. 

Sonuç: Çalışmamızda, çocukluk çağı tik bozukluklarında erkek olgu, erken başlangıç ve çoklu eş tanıların belirgin düzeyde yüksek olduğu bulunmuştur. 











Destekleyen Kurum

ÇALIŞMAMIZIN FİNANSAL DESTEĞİ YOKTUR

Teşekkür

YOK

Kaynakça

  • American Psychiatric Association. DSM-5 Task Force, Diagnostic and Statistical Manual of Mental Disorders: DSM-5,5thed.Washington, D.C:American Psychiatric Association, 2013.
  • Blackburn JS. Tic Disorders and PANDAS. Semin Pediatr Neurol. 2018 Apr;25:25-33.
  • Carulla-Roig M, Isomura K, Pérez-Vigil A, Larsson H, Hellner C, Mataix-Cols D, Fernández de la Cruz L. Pharmacoepidemiology of Tourette and Chronic Tic Disorders in Sweden 2005–2013. J Child Adolesc Psychopharmacol. 2018 Jun 5.
  • Dale RC. Tics and Tourette: a clinical, pathophysiological and etiological review. Curr Opin Pediatr. 2017 Dec;29(6):665-673.
  • Groth C, Mol Debes N, Rask CU, Lange T, Skov L.Course of Tourette Syndrome and Comorbidities in a Large Prospective Clinical Study. J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):304-312. doi: 10.1016/j.jaac.2017.01.010. Epub 2017 Feb 2.
  • Pringsheim T. Tic Severity and Treatment in Children: The Effect of Comorbid Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Behaviors.Child Psychiatry Hum Dev. 2017 Dec;48(6):960-966
  • Meier SM, Dalsgaard S, Mortensen PB, Leckman JF, Plessen KJ. Mortality Risk in a Nationwide Cohort of Individuals With Tic Disorders and With Tourette Syndrome. Mov Disord. 2017 Apr;32(4):605-609.
  • Yang J, Hirsch L, Osland S, Martino D, Jette N, Roberts JI, Pringsheim T. Health status, health related behaviours and chronic health indicators in people with Tourette Syndrome: A Canadian population-based study. Psychiatry Res. 2017 Apr;250:228-233.
  • Sambrani T, Jakubovski E and Müller-Vahl KR (2016) New Insights into Clinical Characteristics of Gilles de la Tourette Syndrome: Findings in 1032 Patients from a Single German Center. Front. Neurosci. 10:415.
  • Yang J, Hirsch L, Martino D, Jette N, Roberts J, Pringsheim T. The Prevalence of Diagnosed Tourette Syndrome in Canada: A National Population-Based Study. Mov Disord. 2016 Nov;31(11):1658-1663.
  • Zoey A. Shaw, Barbara J. Coffey, Tics and Tourette Syndrome. Psychiatr Clin N Am 37 (2014) 269–286
  • Davide Martino, Namrata Madhusudan, Panagiotis Zis, Andrea E. Cavanna.. An Introduction to the Clinical Phenomenology of Tourette Syndrome. Int Rev Neurobiol. 2013; 112:1-33.
  • Leckman JF, Bloch MH, Smith ME, Larabi D, Hampson M. Neurobiological substrates of Tourette’s disorder. J Child Adolesc Psychopharmacol 2010; 20:237-247.
  • Ganos C, Roessner V, Münchau A. The functional anatomy of Gilles de la Tourette syndrome. Neurosci Biobehav Rev 2013; 37:1050-1062.
  • Wanderer S, Roessner V, Freeman R, Bock N, Rothenberger A, Becker A. Relationship of obsessive-compulsive disorder to age-related comorbidity in children and adolescents with Tourette syndrome. J Dev Behav Pediatr 2012; 33:124-133.
  • Jankovic J. Tourette's syndrome. N Engl J Med 2001; 345:1184-1192.
  • Scahill L, Bitsko RH, Visser SN, Blumberg SJ. Prevalence of diagnosed Tourette syndrome in persons aged 6-17 years-United States, 2007. MMWR Morb Mortal Wkly Rep 2009; 58:581-585.
  • Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Dev Med Child Neurol 2000; 42:436-447.
  • Robertson MM. Gilles de la Tourette syndrome: the complexities of phenotype and treatment. Br J Hosp Med (London) 2011; 72:100-107.
  • Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for affective disorders and schizophrenia for school-age Children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36:980-988.
  • Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Reliability And Validity of Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T). Turkish J Cild Adolesc Psychiatry 2004; 11:109-117.,
  • Leckman JF, Riddle MA, Hardin MT, Ort SI, Swartz KL, Stevenson J, Cohen DJ. The Yale Global Tic Severity Scale: Initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 1989; 28:566-573.
  • Zaimoğlu S, Rodopman Arman A, Sabuncuoğlu O. Yale Genel Tik Ağırlığını Derecelendirme Ölçeği’nin Güvenirlik Çalışması. 5. Ulusal Çocuk ve Ergen Psikiyatrisi Kongresi, Ankara-Türkiye, 1995.
  • Scahill L, Sukhodolsky DG, Williams SK, Leckman JF. Public health significance of tic disorders in children and adolescents. Adv Neurol 2005; 96:240-248.
  • Leckman JF, Riddle MA. Tourette’s syndrome: When habit forming units form habits of their own? Neuron 2000; 28:349-354.
  • Leckman JF, Vaccarino FM, Kalanithi PS, Rothenberger A. Tourette syndrome: A relentless drumbeat-driven by misguided brain oscillations. J Child Psychol Psychiatry 2006; 47:537-550.
  • Kalanithi PS, Zheng W, DiFiglia M, Grantz H, Saper CB, Schwartz ML, Leckman JF, Vaccarino FM. Altered parvalbumin-positive neuron distribution in basal ganglia of individuals with Tourette syndrome. Proc Natl Acad Sci USA 2005; 102:13307-13312.
  • Cavanna AE, Servo S, Monaco F, Robertson MM. The behavioral spectrum of Gilles de la Tourette syndrome. J Neuropsychiatry Clin Neurosci 2009; 21:13-23.
  • Cavanna AE, Servo S, Monaco F, Robertson MM. The behavioral spectrum of Gilles de la Tourette syndrome. J Neuropsychiatry Clin Neurosci 2009; 21:13-23.
  • Kurlan R, Como PG, Miller B, Palumbo D, Deeley C, Andresen EM, Eapen S, McDermott MP. The behavioral spectrum of tic disorders: a community based study? Neurology 2002; 59:414-420.
  • Hoekstra PJ, Anderson GM, Limburg PC, Korf J, Kallenberg CGM, Minderaa RB. Neurobiology and neuroimmunology of Tourette’s syndrome: an update. Cell Mol Life Sci 2004; 61:886-898.
  • Bronfeld M, Bar-Gad I. Tic Disorders: What Happens in the Basal Ganglia? Neuroscientist 2013; 19:101-108.
  • Buse J, Schoenefeld K, Münchau A, Roessner V. Neuromodulation in Tourette syndrome: Dopamine and beyond. Neurosci Biobehav Rev 2013; 37:1069-1084.
  • Harris K, Singer HS. Tic disorders: neural circuits, neurochemistry, and neuroimmunology. J Child Neurol 2004; 21:678-689.
  • Burd L, Freeman RD, Klug MG, Kerbeshian J. Tourette Syndrome and learning disabilities. BMC Pediatr 2005; 5:34.
  • Hesapçıoğlu ST, Tural MK, Kandil S. Kronik Tik Bozukluklarında Sosyodemografik, Klinik Özellikler ve Risk Etmenleri. Türk Psikiyatri 2013; 24
  • Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009; 67:497-501.
  • Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009; 67:497-501.
  • Toros F, Tot Ş, Avcı A. Çocuk Ve Ergenlerde Tourette Bozukluğu: Sosyodemografik, KlinikÖzellikler Ve Eştanılar. TürkPsikiyatr 2002; 13:187-196.

Sociodemographic and clinical characteristics of childhood tic disorders

Yıl 2019, Cilt: 44 Sayı: Ek 1, 251 - 262, 29.12.2019
https://doi.org/10.17826/cumj.628103

Öz

Purpose: In this study, we aimed to investigate the sociodemographic and clinical characteristics of children and adolescents diagnosed with tic disorders.

Materials and Methods: The study population included 187 children with tic disorders, aged between 4 and 18 years. The data were obtained by using Yale Global Tic Severity Scale (YGTSS), Screen for Child Anxiety and Related Disorders, Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). The demographic information, history of familial diseases were recorded. 

Results: The study included 37 girls (mean 10.9 ± 2.5 years) and 150 boys (mean 10.9 ± 2.7 years) with a mean age of 10.9 ± 2.6 years. Of all cases, 135 were classified as Tourette Syndrome (n=135; 72,2%), 50 as motor tics (n=50; 26,7 %) and 2 as others tic disorders (n=2; 1,1%) according to the diagnostic tic disorders subtype. There was no significant difference between the two groups in terms of mean age and first symptom age according to the subtype of tic disorder. In 91% of the cases, the age of onset of tics was 12 years or younger. The rate of having at least one comorbidity, mean number of comorbidities and comorbid ADHD rates were significantly higher among boys than girls. The most common comorbid diagnoses were ADHD (n=142, 75.9%), OCD (n= 08, 57.8%) and anxiety disorder (n=57, 30.4%). 

Conclusion: In our study, male cases, early onset and multiple comorbid diagnoses were found to be significantly higher in childhood tic disorders. 


Kaynakça

  • American Psychiatric Association. DSM-5 Task Force, Diagnostic and Statistical Manual of Mental Disorders: DSM-5,5thed.Washington, D.C:American Psychiatric Association, 2013.
  • Blackburn JS. Tic Disorders and PANDAS. Semin Pediatr Neurol. 2018 Apr;25:25-33.
  • Carulla-Roig M, Isomura K, Pérez-Vigil A, Larsson H, Hellner C, Mataix-Cols D, Fernández de la Cruz L. Pharmacoepidemiology of Tourette and Chronic Tic Disorders in Sweden 2005–2013. J Child Adolesc Psychopharmacol. 2018 Jun 5.
  • Dale RC. Tics and Tourette: a clinical, pathophysiological and etiological review. Curr Opin Pediatr. 2017 Dec;29(6):665-673.
  • Groth C, Mol Debes N, Rask CU, Lange T, Skov L.Course of Tourette Syndrome and Comorbidities in a Large Prospective Clinical Study. J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):304-312. doi: 10.1016/j.jaac.2017.01.010. Epub 2017 Feb 2.
  • Pringsheim T. Tic Severity and Treatment in Children: The Effect of Comorbid Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Behaviors.Child Psychiatry Hum Dev. 2017 Dec;48(6):960-966
  • Meier SM, Dalsgaard S, Mortensen PB, Leckman JF, Plessen KJ. Mortality Risk in a Nationwide Cohort of Individuals With Tic Disorders and With Tourette Syndrome. Mov Disord. 2017 Apr;32(4):605-609.
  • Yang J, Hirsch L, Osland S, Martino D, Jette N, Roberts JI, Pringsheim T. Health status, health related behaviours and chronic health indicators in people with Tourette Syndrome: A Canadian population-based study. Psychiatry Res. 2017 Apr;250:228-233.
  • Sambrani T, Jakubovski E and Müller-Vahl KR (2016) New Insights into Clinical Characteristics of Gilles de la Tourette Syndrome: Findings in 1032 Patients from a Single German Center. Front. Neurosci. 10:415.
  • Yang J, Hirsch L, Martino D, Jette N, Roberts J, Pringsheim T. The Prevalence of Diagnosed Tourette Syndrome in Canada: A National Population-Based Study. Mov Disord. 2016 Nov;31(11):1658-1663.
  • Zoey A. Shaw, Barbara J. Coffey, Tics and Tourette Syndrome. Psychiatr Clin N Am 37 (2014) 269–286
  • Davide Martino, Namrata Madhusudan, Panagiotis Zis, Andrea E. Cavanna.. An Introduction to the Clinical Phenomenology of Tourette Syndrome. Int Rev Neurobiol. 2013; 112:1-33.
  • Leckman JF, Bloch MH, Smith ME, Larabi D, Hampson M. Neurobiological substrates of Tourette’s disorder. J Child Adolesc Psychopharmacol 2010; 20:237-247.
  • Ganos C, Roessner V, Münchau A. The functional anatomy of Gilles de la Tourette syndrome. Neurosci Biobehav Rev 2013; 37:1050-1062.
  • Wanderer S, Roessner V, Freeman R, Bock N, Rothenberger A, Becker A. Relationship of obsessive-compulsive disorder to age-related comorbidity in children and adolescents with Tourette syndrome. J Dev Behav Pediatr 2012; 33:124-133.
  • Jankovic J. Tourette's syndrome. N Engl J Med 2001; 345:1184-1192.
  • Scahill L, Bitsko RH, Visser SN, Blumberg SJ. Prevalence of diagnosed Tourette syndrome in persons aged 6-17 years-United States, 2007. MMWR Morb Mortal Wkly Rep 2009; 58:581-585.
  • Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Dev Med Child Neurol 2000; 42:436-447.
  • Robertson MM. Gilles de la Tourette syndrome: the complexities of phenotype and treatment. Br J Hosp Med (London) 2011; 72:100-107.
  • Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for affective disorders and schizophrenia for school-age Children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36:980-988.
  • Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Reliability And Validity of Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T). Turkish J Cild Adolesc Psychiatry 2004; 11:109-117.,
  • Leckman JF, Riddle MA, Hardin MT, Ort SI, Swartz KL, Stevenson J, Cohen DJ. The Yale Global Tic Severity Scale: Initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 1989; 28:566-573.
  • Zaimoğlu S, Rodopman Arman A, Sabuncuoğlu O. Yale Genel Tik Ağırlığını Derecelendirme Ölçeği’nin Güvenirlik Çalışması. 5. Ulusal Çocuk ve Ergen Psikiyatrisi Kongresi, Ankara-Türkiye, 1995.
  • Scahill L, Sukhodolsky DG, Williams SK, Leckman JF. Public health significance of tic disorders in children and adolescents. Adv Neurol 2005; 96:240-248.
  • Leckman JF, Riddle MA. Tourette’s syndrome: When habit forming units form habits of their own? Neuron 2000; 28:349-354.
  • Leckman JF, Vaccarino FM, Kalanithi PS, Rothenberger A. Tourette syndrome: A relentless drumbeat-driven by misguided brain oscillations. J Child Psychol Psychiatry 2006; 47:537-550.
  • Kalanithi PS, Zheng W, DiFiglia M, Grantz H, Saper CB, Schwartz ML, Leckman JF, Vaccarino FM. Altered parvalbumin-positive neuron distribution in basal ganglia of individuals with Tourette syndrome. Proc Natl Acad Sci USA 2005; 102:13307-13312.
  • Cavanna AE, Servo S, Monaco F, Robertson MM. The behavioral spectrum of Gilles de la Tourette syndrome. J Neuropsychiatry Clin Neurosci 2009; 21:13-23.
  • Cavanna AE, Servo S, Monaco F, Robertson MM. The behavioral spectrum of Gilles de la Tourette syndrome. J Neuropsychiatry Clin Neurosci 2009; 21:13-23.
  • Kurlan R, Como PG, Miller B, Palumbo D, Deeley C, Andresen EM, Eapen S, McDermott MP. The behavioral spectrum of tic disorders: a community based study? Neurology 2002; 59:414-420.
  • Hoekstra PJ, Anderson GM, Limburg PC, Korf J, Kallenberg CGM, Minderaa RB. Neurobiology and neuroimmunology of Tourette’s syndrome: an update. Cell Mol Life Sci 2004; 61:886-898.
  • Bronfeld M, Bar-Gad I. Tic Disorders: What Happens in the Basal Ganglia? Neuroscientist 2013; 19:101-108.
  • Buse J, Schoenefeld K, Münchau A, Roessner V. Neuromodulation in Tourette syndrome: Dopamine and beyond. Neurosci Biobehav Rev 2013; 37:1069-1084.
  • Harris K, Singer HS. Tic disorders: neural circuits, neurochemistry, and neuroimmunology. J Child Neurol 2004; 21:678-689.
  • Burd L, Freeman RD, Klug MG, Kerbeshian J. Tourette Syndrome and learning disabilities. BMC Pediatr 2005; 5:34.
  • Hesapçıoğlu ST, Tural MK, Kandil S. Kronik Tik Bozukluklarında Sosyodemografik, Klinik Özellikler ve Risk Etmenleri. Türk Psikiyatri 2013; 24
  • Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009; 67:497-501.
  • Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009; 67:497-501.
  • Toros F, Tot Ş, Avcı A. Çocuk Ve Ergenlerde Tourette Bozukluğu: Sosyodemografik, KlinikÖzellikler Ve Eştanılar. TürkPsikiyatr 2002; 13:187-196.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Psikiyatri
Bölüm Araştırma
Yazarlar

Perihan Çam Ray 0000-0002-6254-6055

Gonca Gül Çelik 0000-0001-6101-0796

Ayşegül Tahiroğlu 0000-0002-3039-2864

Çağlar Charles Daniel Jaicks Bu kişi benim 0000-0003-4428-6912

Ayşe Avcı Bu kişi benim 0000-0001-5450-4659

Yayımlanma Tarihi 29 Aralık 2019
Kabul Tarihi 9 Ekim 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 44 Sayı: Ek 1

Kaynak Göster

MLA Çam Ray, Perihan vd. “Çocukluk çağı Tik bozukluklarının Sosyodemografik Ve Klinik özellikleri”. Cukurova Medical Journal, c. 44, 2019, ss. 251-62, doi:10.17826/cumj.628103.