Sociodemographic and clinical characteristics of children with tic disorders and behavioral problems: A real-world study and development of a prediction model.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967804 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2431 (Electronic) Linking ISSN: 14712431 NLM ISO Abbreviation: BMC Pediatr Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Tic Disorders*/diagnosis ; Tic Disorders*/epidemiology ; Tic Disorders*/psychology ; Tourette Syndrome*/epidemiology ; Tics*/epidemiology ; Tics*/psychology; Humans ; Child ; Adolescent ; Cross-Sectional Studies ; Comorbidity

Background: Tic disorders (TD) are complex neuropsychiatric disorders frequently associated with a variety of comorbid problems, whose negative effects may exceed those of the tics themselves. In this study, we aimed to explore the sociodemographic and clinical characteristics of children with TD and behavioral problems, and develop a prediction model of behavioral problems based on the predictors under real-world conditions.
Methods: A hospital-based cross-sectional study was conducted on children with TD. Behavioral problems were surveyed using the Achenbach Child Behavior Checklist (CBCL). Sociodemographic information was collected from face-to-face interviews using an electronic questionnaire administered during the initial ambulatory visit. Clinical data were collected from medical records, and quality control was performed. The sociodemographic and clinical characteristics of patients with and without behavioral problems were statistically compared, and a nomogram prediction model was developed based on multivariate logistic regression analysis. The discriminatory ability and clinical utility of the nomogram were assessed by concordance index (C-index), receiver operating characteristic (ROC) curve, decision curve analysis (DCA) and clinical impact curve (CIC).
Results: A total of 343 TD cases were included in the final analysis, of which 30.32% had behavioral problems. The prediction model showed age 12-16 years, abnormal birth history, parenting pattern of indulgence, parent/close relatives with psychiatric disorders, chronic motor or vocal tic disorder (CTD)/Tourette syndrome (TS) and moderate/severe tic severity were associated with behavioral problems in children with TD. The C-index of the prediction model (nomogram) was 0.763 (95% confidence interval, 0.710 ~ 0.816). The nomogram was feasible for making beneficial clinical decisions, according to the satisfactory results of the DCA and CIC.
Conclusions: A nomogram prediction model for comorbid behavioral problems in children with TD was established. The prediction model demonstrated a good discriminative ability and predictive performance for beneficial clinical decisions. This model further provides a comprehensive understanding of associated sociodemographic and clinical characteristics by visual graphs and allows clinicians to rapidly identify patients with a higher risk of behavioral problems and tailor necessary interventions to improve clinical outcomes.
(© 2023. The Author(s).)

J Am Acad Child Adolesc Psychiatry. 2010 Mar;49(3):217-28.e1-3. (PMID: 20410711)
Psychiatry Res. 2016 Sep 30;243:263-7. (PMID: 27423633)
BMC Public Health. 2010 Aug 19;10:503. (PMID: 20723230)
Br J Psychiatry. 2014 Jan;204(1):40-5. (PMID: 24262815)
J Paediatr Child Health. 2018 Oct;54(10):1148-1153. (PMID: 30294996)
J Neurotrauma. 2022 Mar;39(5-6):371-378. (PMID: 35018830)
Eur Child Adolesc Psychiatry. 2020 May;29(5):617-624. (PMID: 31396706)
JAMA Psychiatry. 2015 Apr;72(4):325-33. (PMID: 25671412)
Neurosci Biobehav Rev. 2011 Aug;35(8):1687-703. (PMID: 21600919)
PLoS One. 2020 Oct 12;15(10):e0239092. (PMID: 33044960)
Eur Child Adolesc Psychiatry. 2021 Feb;30(2):233-241. (PMID: 32172341)
Monogr Soc Res Child Dev. 1981;46(1):1-82. (PMID: 7242540)
Clin Interv Aging. 2021 Jul 24;16:1439-1447. (PMID: 34335022)
Eur J Paediatr Neurol. 2018 Sep;22(5):749-756. (PMID: 29859653)
Front Psychiatry. 2020 Aug 13;11:774. (PMID: 32903695)
Pediatr Neurol. 2020 Apr;105:48-54. (PMID: 32029331)
Brain Dev. 2007 Aug;29(7):413-20. (PMID: 17280810)
BMC Public Health. 2022 Mar 2;22(1):416. (PMID: 35232400)
Front Neurosci. 2016 Aug 03;10:351. (PMID: 27536211)
Eur Child Adolesc Psychiatry. 2022 Oct;31(10):1539-1548. (PMID: 33944988)
Soc Psychiatry Psychiatr Epidemiol. 2019 Jun;54(6):661-670. (PMID: 30535676)
Medicine (Baltimore). 2016 Jul;95(30):e4354. (PMID: 27472724)
Brain Dev. 2009 Jan;31(1):15-9. (PMID: 18558469)
Curr Dev Disord Rep. 2021 Jun;8(2):121-132. (PMID: 34178575)
Neuroimage. 2013 Dec;83:690-703. (PMID: 23845427)
Eur Child Adolesc Psychiatry. 2017 Jan;26(1):99-109. (PMID: 27277754)
Chang Gung Med J. 2008 Mar-Apr;31(2):145-52. (PMID: 18567414)
J Am Acad Child Adolesc Psychiatry. 2017 Jun;56(6):466-474. (PMID: 28545751)
World J Gastroenterol. 2022 Aug 28;28(32):4681-4697. (PMID: 36157936)
Psychiatry Res. 2018 Feb;260:1-9. (PMID: 29153958)
Ann Am Thorac Soc. 2020 Mar;17(3):293-301. (PMID: 31689128)
J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):304-312. (PMID: 28335874)
Dev Med Child Neurol. 2000 Jul;42(7):436-47. (PMID: 10972415)
PLoS One. 2019 Oct 24;14(10):e0223970. (PMID: 31647827)
Am J Public Health. 2015 Mar;105(3):e122-32. (PMID: 25602890)
Compr Psychiatry. 2013 Jul;54(5):462-6. (PMID: 23332555)
PLoS One. 2018 May 24;13(5):e0197961. (PMID: 29795678)
Epilepsy Behav. 2021 Jan;114(Pt A):107477. (PMID: 33288402)
Res Dev Disabil. 2021 Dec;119:104106. (PMID: 34656889)
J Am Acad Child Adolesc Psychiatry. 1989 Jul;28(4):566-73. (PMID: 2768151)
Zhonghua Er Ke Za Zhi. 2010 May;48(5):342-5. (PMID: 20654033)
J Clin Med. 2021 Jun 03;10(11):. (PMID: 34204991)
J Abnorm Child Psychol. 2016 Oct;44(7):1411-23. (PMID: 26767832)

TFLC2018001 Medical Science Advancement Program of Wuhan University

Keywords: Behavioral problems; Children; Clinical characteristics; Nomogram; Sociodemographic characteristics; Tic disorders

Date Created: 20230203 Date Completed: 20230206 Latest Revision: 20230223

20240105

PMC9893666

10.1186/s12887-023-03864-y

36732748