Joseph L Smith1, Sean Gregory1, Nicole McBride2, Tanya K Murphy3,4,5, Eric A Storch1,2,3,6,4,5. 1. Department of Health Policy and Management College of Public Health University of South Florida Tampa Florida USA. 2. Department of Psychology University of South Florida Tampa Florida USA. 3. Department of Pediatrics University of South Florida Tampa Florida USA. 4. All Children's Hospital-Johns Hopkins Medicine Baltimore Maryland USA. 5. Department of Psychiatry and Behavioral Neurosciences University of South Florida Tampa Florida USA. 6. Rogers Behavioral Health-Tampa Bay Tampa Florida USA.
Abstract
INTRODUCTION: Limited information is available regarding treatment practices in applied settings for children and adults with tic disorders (TDs). We describe, for the first time, the treatment of TDs in U.S. children and adults in the outpatient setting. METHODS: Data from the 2003-2010 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey were used. Descriptive statistics for modality of treatment and class of pharmacological medications were reported by patient and visit characteristics. Separate multivariable logistic regression models were used to examine associations between patient and visit characteristics and classes of medications prescribed. RESULTS: One third (n = 99) of the sample did not receive any psychiatric or psychological treatment. Nearly two-thirds received a psychotropic medication. The most common class of medication was alpha-2 agonists (25%), followed by stimulants (23%), serotonin-reuptake inhibitors (SRIs) (19%), atypical antipsychotics (18%), anxiolytics (14%), anticonvulsants (11%), and typical antipsychotics (8%). Comorbid disorders and chronicity of problems were significantly associated with the receipt of certain classes of medications. Relatively few patients (18%) received psychotherapy. CONCLUSIONS: If the decision is made to treat tic disorders, the choice of medication is dependent on the primary complaints, severity, chronicity, and the presence of comorbid psychiatric disorders. In general, comorbid externalizing, anxiety and mood disorders appear to influence treatment decisions in addition to TDs.
INTRODUCTION: Limited information is available regarding treatment practices in applied settings for children and adults with tic disorders (TDs). We describe, for the first time, the treatment of TDs in U.S. children and adults in the outpatient setting. METHODS: Data from the 2003-2010 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey were used. Descriptive statistics for modality of treatment and class of pharmacological medications were reported by patient and visit characteristics. Separate multivariable logistic regression models were used to examine associations between patient and visit characteristics and classes of medications prescribed. RESULTS: One third (n = 99) of the sample did not receive any psychiatric or psychological treatment. Nearly two-thirds received a psychotropic medication. The most common class of medication was alpha-2 agonists (25%), followed by stimulants (23%), serotonin-reuptake inhibitors (SRIs) (19%), atypical antipsychotics (18%), anxiolytics (14%), anticonvulsants (11%), and typical antipsychotics (8%). Comorbid disorders and chronicity of problems were significantly associated with the receipt of certain classes of medications. Relatively few patients (18%) received psychotherapy. CONCLUSIONS: If the decision is made to treat tic disorders, the choice of medication is dependent on the primary complaints, severity, chronicity, and the presence of comorbid psychiatric disorders. In general, comorbid externalizing, anxiety and mood disorders appear to influence treatment decisions in addition to TDs.
Authors: Joseph F McGuire; John Piacentini; Adam B Lewin; Erin A Brennan; Tanya K Murphy; Eric A Storch Journal: Depress Anxiety Date: 2015-06-30 Impact factor: 6.505
Authors: Joseph F McGuire; John Piacentini; Erin A Brennan; Adam B Lewin; Tanya K Murphy; Brent J Small; Eric A Storch Journal: J Psychiatr Res Date: 2013-12-28 Impact factor: 4.791
Authors: Matthew E Hirschtritt; Paul C Lee; David L Pauls; Yves Dion; Marco A Grados; Cornelia Illmann; Robert A King; Paul Sandor; William M McMahon; Gholson J Lyon; Danielle C Cath; Roger Kurlan; Mary M Robertson; Lisa Osiecki; Jeremiah M Scharf; Carol A Mathews Journal: JAMA Psychiatry Date: 2015-04 Impact factor: 21.596
Authors: Sabine Wilhelm; Alan L Peterson; John Piacentini; Douglas W Woods; Thilo Deckersbach; Denis G Sukhodolsky; Susanna Chang; Haibei Liu; James Dziura; John T Walkup; Lawrence Scahill Journal: Arch Gen Psychiatry Date: 2012-08