1. Clinical characterization and follow-up of Provisional Tic Disorder
- Author
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Arbuckle, A. L., Ueda, K., Bihun, E. C., Song, D. Y., Koller, J. M., Reiersen, A. M., Schlaggar, B. L., Greene, D. L., and Black, Kevin J.
- Subjects
tic disorders ,Tourette syndrome ,Provisional Tic Disorder - Abstract
Background: The received wisdom among clinicians has been Provisional Tic Disorder (PTD)—tics now but never a year or more ago—is generally short-lived and mild, includes few tics, and rarely includes complex tics, premonitory phenomena or comorbid illnesses. However, such conclusions come from clinical experience. Objective: To test these views with thorough, prospectively acquired data. Methods: Prospective study of 89 children with tics starting 0-9 months ago (median 4); follow-up at 12 (± 24, 36, 48) months after the first tic. Results: Most had an anxiety disorder (54), ADHD (39), OCD (17) or enuresis (25). ASD symptoms were not overrepresented (SRS T-score 50.3 ± 10.0). After initial history, PI was confident of a past-week tic in only 49 of 59, but after extended observation all had 2+ current tics and a lifetime total of 6.7 ± 4.2 motor and 2.2 ± 1.7 phonic tics. 42 had had a complex tic and 69 had some tic suppression. Total tic score was > 13 in 61/89, impairment was ≥ 20 in 13/88, and 53/62 had recent or planned doctor visits for the tics. At 12 months, 79 returned, and 78 still had tics. However, most (67) had no current plans to see a doctor for tics. Most who returned at 2-4 years still had tics known to child and family, but medical impact was low. Conclusion: Our results are consistent with previous observations but overturn clinical lore.
- Published
- 2023
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