Carly Johnco1, Joseph F McGuire2, Nicole M McBride3, Tanya K Murphy4, Adam B Lewin5, Eric A Storch6. 1. Department of Pediatrics, University of South Florida, USA; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: carly.johnco@mq.edu.au. 2. Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA. 3. Department of Pediatrics, University of South Florida, USA. 4. Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA; All Children's Hospital - Johns Hopkins Medicine, St Petersburg, FL, USA. 5. Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA; Department of Psychology, University of South Florida, USA. 6. Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA; All Children's Hospital - Johns Hopkins Medicine, St Petersburg, FL, USA; Department of Psychology, University of South Florida, USA; Department of Health Policy and Management, University of South Florida, USA; Rogers Behavioral Health - Tampa Bay, Tampa, FL, USA.
Abstract
BACKGROUND: This study examined the incidence and clinical correlates of suicidal ideation (SI) in youth with tic disorders (TD). The independent contribution of tics, anxiety, depressive and externalizing symptoms on SI severity in youth with TD was assessed. METHOD: Participants were 75 treatment-seeking youth with a TD (N=75) aged 6-18. Participants completed diagnostic assessments, clinician-ratings, self- and parent-report measures of emotional functioning and the presence and/or severity of suicidal ideation. RESULTS: Based on youth-report, 61% of youth endorsed at least some symptoms of SI, and 8% endorsed symptoms that exceeded the clinically significant cut-off. Parents reported SI in 11% of cases, with generally poor agreement between parent- and youth-report. Suicidal ideation correlated with higher anxiety, depressive and externalizing symptoms, affective lability, and with poorer distress tolerance and overall functioning. Anxiety, depressive and externalizing symptoms showed an independent relationship with SI. Tic severity was not associated with SI. Rather, higher tic severity was associated with an increase in anxiety symptoms, which in turn, was associated with greater SI severity. LIMITATIONS: Cross-sectional data limits causal conclusions. Diagnosis was based on unstructured assessments by expert clinicians, including consensus diagnosis, rather than structured clinical interviews. CONCLUSIONS: Around 8-11% of youth with TD experienced SI. Tic severity did not have any direct influence on SI, however the presence of comorbid anxiety and depressive symptoms significantly increases this risk. Results suggest that it is psychiatric comorbidity, rather than tics themselves, that predispose youth with tic disorders to increased risk of suicidality.
BACKGROUND: This study examined the incidence and clinical correlates of suicidal ideation (SI) in youth with tic disorders (TD). The independent contribution of tics, anxiety, depressive and externalizing symptoms on SI severity in youth with TD was assessed. METHOD:Participants were 75 treatment-seeking youth with a TD (N=75) aged 6-18. Participants completed diagnostic assessments, clinician-ratings, self- and parent-report measures of emotional functioning and the presence and/or severity of suicidal ideation. RESULTS: Based on youth-report, 61% of youth endorsed at least some symptoms of SI, and 8% endorsed symptoms that exceeded the clinically significant cut-off. Parents reported SI in 11% of cases, with generally poor agreement between parent- and youth-report. Suicidal ideation correlated with higher anxiety, depressive and externalizing symptoms, affective lability, and with poorer distress tolerance and overall functioning. Anxiety, depressive and externalizing symptoms showed an independent relationship with SI. Tic severity was not associated with SI. Rather, higher tic severity was associated with an increase in anxiety symptoms, which in turn, was associated with greater SI severity. LIMITATIONS: Cross-sectional data limits causal conclusions. Diagnosis was based on unstructured assessments by expert clinicians, including consensus diagnosis, rather than structured clinical interviews. CONCLUSIONS: Around 8-11% of youth with TD experienced SI. Tic severity did not have any direct influence on SI, however the presence of comorbid anxiety and depressive symptoms significantly increases this risk. Results suggest that it is psychiatric comorbidity, rather than tics themselves, that predispose youth with tic disorders to increased risk of suicidality.
Authors: Eric A Storch; Tanya K Murphy; Melanie Fernandez; Mohan Krishnan; Gary R Geffken; Ashley R Kellgren; Wayne K Goodman Journal: Psychiatry Res Date: 2006-12-05 Impact factor: 3.222
Authors: B Birmaher; D A Brent; L Chiappetta; J Bridge; S Monga; M Baugher Journal: J Am Acad Child Adolesc Psychiatry Date: 1999-10 Impact factor: 8.829
Authors: Andre Sourander; Anat Brunstein Klomek; Solja Niemelä; Antti Haavisto; David Gyllenberg; Hans Helenius; Lauri Sillanmäki; Terja Ristkari; Kirsti Kumpulainen; Tuula Tamminen; Irma Moilanen; Jorma Piha; Fredrik Almqvist; Madelyn S Gould Journal: Arch Gen Psychiatry Date: 2009-04
Authors: J F Leckman; M A Riddle; M T Hardin; S I Ort; K L Swartz; J Stevenson; D J Cohen Journal: J Am Acad Child Adolesc Psychiatry Date: 1989-07 Impact factor: 8.829
Authors: Denis G Sukhodolsky; Lawrence Scahill; Heping Zhang; Bradley S Peterson; Robert A King; Paul J Lombroso; Lily Katsovich; Diane Findley; James F Leckman Journal: J Am Acad Child Adolesc Psychiatry Date: 2003-01 Impact factor: 8.829
Authors: Joseph F McGuire; John Piacentini; Eric A Storch; Emily J Ricketts; Douglas W Woods; Alan L Peterson; John T Walkup; Sabine Wilhelm; Kesley Ramsey; Joey K-Y Essoe; Michael B Himle; Adam B Lewin; Susanna Chang; Tanya K Murphy; James T McCracken; Lawrence Scahill Journal: J Psychiatr Res Date: 2020-12-13 Impact factor: 4.791
Authors: Barbara Coffey; Joseph Jankovic; Daniel O Claassen; Joohi Jimenez-Shahed; Barry J Gertz; Elizabeth A Garofalo; David A Stamler; Maria Wieman; Juha-Matti Savola; Mark Forrest Gordon; Jessica K Alexander; Hadas Barkay; Eran Harary Journal: JAMA Netw Open Date: 2021-10-01
Authors: Kesley A Ramsey; Alessandro S De Nadai; Flint M Espil; Emily Ricketts; Jordan T Stiede; Jennifer Schild; Matthew W Specht; Douglas W Woods; Shannon Bennet; John T Walkup; Susanna Chang; John Piacentini; Joseph F McGuire Journal: Front Psychiatry Date: 2022-08-10 Impact factor: 5.435