Symptom Severity and Health Impacts of Functional Tic-Like Behaviors in Youth

Lindsay Berg; Davide Martino; Z Paige L'Erario; Tamara Pringsheim

doi:10.1016/j.pediatrneurol.2024.03.016

Symptom Severity and Health Impacts of Functional Tic-Like Behaviors in Youth

Pediatr Neurol. 2024 Mar 22:155:68-75. doi: 10.1016/j.pediatrneurol.2024.03.016. Online ahead of print.

Authors

Lindsay Berg¹, Davide Martino¹, Z Paige L'Erario², Tamara Pringsheim³

Affiliations

¹ Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
² Greenburgh Pride, Westchester, New York.
³ Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: tamara.pringsheim@ucalgary.ca.

PMID: 38603984
DOI: 10.1016/j.pediatrneurol.2024.03.016

Abstract

Background: We performed this study to improve understanding of the relationship between functional tic-like behaviors (FTLBs) and quality of life, loneliness, family functioning, anxiety, depression, and suicidality.

Method: This cross-sectional study assessed self-reported quality of life, disability, loneliness, depression, anxiety, family functioning, tic severity, and suicide risk in age- and birth-sex matched youth with FTLBs, Tourette syndrome (TS), and neurotypical controls. We performed specific subanalyses comparing individuals with FTLBs who identified as transgender/gender diverse (TGD) with cisgender individuals.

Results: Eighty-two youth participated (age range 11 to 25, 90% female at birth), including 35 with FTLBs, 22 with TS, and 25 neurotypical controls. A significantly higher proportion of participants with FTLB identified as TGD (15 of 35) than TS (two of 22) and neurotypical control (three of 25) participants. Compared with neurotypical controls, individuals with FTLBs had significantly lower quality of life, greater disability, loneliness, social phobia, anxiety symptoms, depressive symptoms, and suicidality. Compared with individuals with TS, individuals with FTLBs had more school/work absences due to tics, had more depressive symptoms, were more likely to be at high risk for suicidality, and had disability in self-care and life activity domains. There were no significant differences between cisgender and TGD participants with FTLB in any of the domains assessed.

Conclusions: Youth with FTLB have unique health care needs and associations with anxiety, depression, sex, and gender.

Keywords: Functional neurological disorders; Quality of life; Tourette syndrome; Transgender identity.