Suicidal Thoughts and Behaviors in Children and Adolescents with Chronic Tic Disorders
Published Date:Feb 24 2015
Source:Depress Anxiety. 32(10):744-753.
Pubmed Central ID:PMC4547888
Funding:CC999999/Intramural CDC HHS/United States
K12 NS066098/NS/NINDS NIH HHS/United States
U01DD000509-01/DD/NCBDD CDC HHS/United States
Despite evidence of elevated risk factors for suicidal thoughts and behavior in youth with Tourette syndrome and chronic tic disorders (CTD), few studies have actually examined that relationship. This study documented the frequency and clinical correlates of suicidal thoughts and behaviors in a sample of children and adolescents with CTD (N=196; range 6-18 years old).
Youth and parents completed a battery of measures that assessed co-occurring psychiatric diagnoses, child emotional and behavioral symptoms, and impairment due to tics or co-occurring conditions.
A structured diagnostic interview identified that 19 youths with CTD (9.7%) experienced suicidal thoughts and/or behaviors, which was elevated compared to three youths (3%) who experienced these thoughts in a community control sample (N=100; range 6-18 years old; p = 0.03). For youth with CTD, suicidal thoughts and behaviors were frequently endorsed in the context of anger and frustration. The Child Behavior Checklist (CBCL) anxious/depressed, withdrawn, social problems, thought problems, and aggressive behavior subscales, as well as the total internalizing problems scale were associated with the presence of suicidal thoughts and/or behaviors. Suicidal thoughts and/or behaviors were significantly associated with tic symptom severity, tic-related impairment, and obsessive-compulsive, depressive, anxiety, and attention-deficit/hyperactivity disorder symptom severity. CBCL anxiety/depression scores mediated the relationship between tic severity and suicidal thoughts and behaviors.
Findings suggest that about 1 in 10 youth with CTD experience suicidal thoughts and/or behaviors, which are associated with a more complex clinical presentation and often occur in the presence of anger and frustration.
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