Skip to main content

Emotional development in children with tics: a longitudinal population-based study

European Child & Adolescent Psychiatry volume 22, pages 185–192 (2013)Cite this article

Abstract

Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the developmental trajectory of children with and without tics when they were 7–9 years old. Parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ) when the children were 7–9 years (wave 1) and 4 years later (wave 2). Using strict criteria, we identified 38 children with tics in the cohort of 4,025 children (0.94 % of the total cohort) with a preponderance of boys (78.9 %). 22 children (57.9 %) in the group with tics had only motor tics, and 16 (42.1 %) had both motor and vocal tics. Children with tics had significantly higher parent- and teacher-rated SDQ total difficulty scores and subscale scores in both waves. Children with tics experienced an increase in emotional problems and in peer problems between the first and the second wave. This study in a general population indicates that the presence of tics is associated with a range of internalizing and externalizing difficulties, as well as problems in peer relationships. Moreover, our study indicates that emotional and peer problems tend to increase over time in the group of children with tics.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Robertson MM (2006) Mood disorders and Gilles de la Tourette’s syndrome: an update on prevalence, etiology, comorbidity, clinical associations, and implications. J Psychosom Res 61:349–358

    PubMed  Article  Google Scholar 

  2. Gilles de la Tourette G (1885) Étude sur une affection nerveuse caracterisée par l’incoordination motrice accompagnée d’écholalie et de coprolalie 1885. Archives de Neurologie 9:19–42, 158-200

    Google Scholar 

  3. Bernard BA, Stebbins GT, Siegel S et al (2009) Determinants of quality of life in children with Gilles de la Tourette syndrome. Mov Disord 24:1070–1073

    PubMed  Article  Google Scholar 

  4. Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P (2000) An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Dev Med Child Neurol 42:436–447

    PubMed  Article  CAS  Google Scholar 

  5. Kadesjö B, Gillberg C (2000) Tourette’s disorder: epidemiology and comorbidity in primary school children. J Am Acad Child Adolesc Psychiatry 39:548–555

    PubMed  Article  Google Scholar 

  6. Khalifa N, von Knorring AL (2006) Psychopathology in a Swedish population of school children with tic disorders. J Am Acad Child Adolesc Psychiatry 45:1346–1353

    PubMed  Article  Google Scholar 

  7. Bloch MH, Peterson BS, Scahill L et al (2006) Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome. Arch Pediatr Adolesc Med 160:65–69

    PubMed  Article  Google Scholar 

  8. Leckman JF, Zhang H, Vitale A et al (1998) Course of tic severity in Tourette syndrome: the first two decades. Pediatrics 102:14–19

    PubMed  Article  CAS  Google Scholar 

  9. Spencer T, Biederman M, Coffey B, Geller D, Wilens T, Faraone S (1999) The 4-year course of tic disorders in boys with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 56:842–847

    PubMed  Article  CAS  Google Scholar 

  10. Pappert EJ, Goetz CG, Louis ED, Blasucci L, Leurgans S (2003) Objective assessments of longitudinal outcome in Gilles de la Tourette’s syndrome. Neurology 61:936–940

    PubMed  Article  CAS  Google Scholar 

  11. Gorman DA, Thompson N, Plessen KJ, Robertson MM, Leckman JF, Peterson BS (2010) Psychosocial outcome and psychiatric comorbidity in older adolescents with Tourette syndrome: controlled study. Br J Psychiatry 197:36–44

    PubMed  Article  Google Scholar 

  12. Apter A, Pauls DL, Bleich A et al (1992) A population-based epidemiological study of Tourette syndrome among adolescents in Israel. Adv Neurol 58:61–65

    PubMed  CAS  Google Scholar 

  13. Goodman R (1999) The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 40:791–799

    PubMed  Article  CAS  Google Scholar 

  14. Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345

    PubMed  Article  CAS  Google Scholar 

  15. Heiervang E, Stormark KM, Lundervold AJ et al (2007) Psychiatric disorders in Norwegian 8-to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 46:438–447

    PubMed  Article  Google Scholar 

  16. Stormark KM, Heiervang E, Heimann M, Lundervold AJ, Gillberg C (2008) Predicting nonresponse bias from teacher ratings of mental health problems in primary school children. J Abnorm Child Psychol 36:411–419

    PubMed  Article  Google Scholar 

  17. Obel C, Heiervang E, Rodriguez A et al (2004) The Strengths and Difficulties Questionnaire in the Nordic countries. Eur Child Adolesc Psychiatry 13:32–39

    Article  Google Scholar 

  18. Roessner V, Becker A, Banaschewski T, Freeman RD, Rothenberger A, Tourette Syndrome International Database Consortium (2007) Developmental psychopathology of children and adolescents with Tourette syndrome–impact of ADHD. Eur Child Adolesc Psychiatry 16:24–35

    PubMed  Article  Google Scholar 

  19. Pollak Y, Benarroch F, Kanengisser L et al (2009) Tourette syndrome-associated psychopathology: roles of comorbid attention-deficit hyperactivity disorder and obsessive-compulsive disorder. J Dev Behav Pediatr 30:413–419

    PubMed  Article  Google Scholar 

  20. Cohen E, Sade M, Benarroch F, Pollak Y, Gross-Tsur V (2008) Locus of control, perceived parenting style, and symptoms of anxiety and depression in children with Tourette’s syndrome. Eur Child Adolesc Psychiatry 17:299–305

    PubMed  Article  Google Scholar 

  21. Wanderer S, Roessner V, Freeman R, Bock N, Rothenberger A, Becker A (2012) Relationship of obsessive-compulsive disorder to age-related comorbidity in children and adolescents with Tourette syndrome. J Dev Behav Pediatr 33:124–133

    PubMed  Google Scholar 

  22. Peterson BS, Pine DS, Cohen P, Brook JS (2001) Prospective, longitudinal study of tic, obsessive–compulsive, and attention-deficit/hyperactivity disorders in an epidemiological sample. J Am Acad Child Adolesc Psychiatry 40:685–695

    PubMed  Article  CAS  Google Scholar 

  23. Khalifa N, von Knorring AL (2005) Tourette syndrome and other tic disorders in a total population of children: clinical assessment and background. Acta Paediatr 94:1608–1614

    PubMed  Article  Google Scholar 

  24. Carter AS, O’Donnell DA, Schultz RT, Scahill L, Leckman JF, Pauls DL (2000) Social and emotional adjustment in children affected with Gilles de la Tourette’s syndrome: associations with ADHD and family functioning. Attention Deficit Hyperactivity Disorder. J Child Psychol Psychiatry 41:215–223

    PubMed  Article  CAS  Google Scholar 

  25. O’Rourke JA, Scharf JM, Yu D, Pauls DL (2009) The genetics of Tourette syndrome: a review. J Psychosom Res 67(6):533–545

    PubMed  Article  Google Scholar 

  26. Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P, International Database Consortium (2000) An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries. Dev Med Child Neurol 42:436–447

    PubMed  Article  CAS  Google Scholar 

  27. Bloch MH, Peterson BS, Scahill L, Otka J, Katsovich L, Zhang H, Leckman JF (2006) Adulthood outcome of tic and obsessive–compulsive symptom severity in children with Tourette syndrome. Arch Pediatr Adolesc Med 160(1):65–69

    PubMed  Article  Google Scholar 

  28. Stokes A, Bawden HN, Camfield PR, Backman JE, Dooley JM (1991) Peer problems in Tourette’s disorder. Pediatrics 87:936–942

    PubMed  CAS  Google Scholar 

  29. Salbach-Andrae H, Lenz K, Lehmkuhl U (2009) Patterns of agreement among parent, teacher and youth ratings in a referred sample. Eur Psychiatry 24:345–351

    PubMed  Article  Google Scholar 

  30. Robertson MM (2008) The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 1: the epidemiological and prevalence studies. J Psychosom Res 65:461–472

    PubMed  Article  Google Scholar 

  31. Woods DW, Marcks BA (2005) Controlled evaluation of an educational intervention used to modify peer attitudes and behavior toward persons with Tourette’s Syndrome. Behav Modif 29:900–912

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

We greatly appreciate the participants of the present study and the project group of the Bergen Child Study. The study was supported by the Norwegian Directorate for Health and Social Affairs, the Norwegian Research Council, Western Norway Regional Health Authority (MoodNet), the City of Bergen, and Uni Research.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Affiliations

  1. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands

    P. J. Hoekstra

  2. Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway

    A. J. Lundervold

  3. Centre for Child and Adolescent Mental Health and Welfare, Uni Health, Bergen, Norway

    A. J. Lundervold, S. A. Lie & C. Gillberg

  4. Gillberg Neuropsychiatry Center, Salgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    C. Gillberg

  5. Institute for Neurology, Psychiatry and Sensory Sciences, University of Copenhagen, Copenhagen, Denmark

    Kerstin J. Plessen

  6. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Kerstin J. Plessen

  7. Mental Health Centre for Child and Adolescent Psychiatry, Bispebjerg Bakke 30, 2400, Copenhagen NV, Denmark

    Kerstin J. Plessen

Authors
  1. P. J. Hoekstra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. J. Lundervold
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. A. Lie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Gillberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kerstin J. Plessen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kerstin J. Plessen.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hoekstra, P.J., Lundervold, A.J., Lie, S.A. et al. Emotional development in children with tics: a longitudinal population-based study. Eur Child Adolesc Psychiatry 22, 185–192 (2013). https://doi.org/10.1007/s00787-012-0337-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-012-0337-y

Keywords

  • Tics
  • Population-based
  • Emotional problems
  • Development