A cluster analysis of tic symptoms in children and adults with Tourette syndrome: clinical correlates and treatment outcome

Psychiatry Res. 2013 Dec 30;210(3):1198-204. doi: 10.1016/j.psychres.2013.09.021. Epub 2013 Sep 27.

Abstract

Cluster analytic methods have examined the symptom presentation of chronic tic disorders (CTDs), with limited agreement across studies. The present study investigated patterns, clinical correlates, and treatment outcome of tic symptoms. 239 youth and adults with CTDs completed a battery of assessments at baseline to determine diagnoses, tic severity, and clinical characteristics. Participants were randomly assigned to receive either a comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). A cluster analysis was conducted on the baseline Yale Global Tic Severity Scale (YGTSS) symptom checklist to identify the constellations of tic symptoms. Four tic clusters were identified: Impulse Control and Complex Phonic Tics; Complex Motor Tics; Simple Head Motor/Vocal Tics; and Primarily Simple Motor Tics. Frequencies of tic symptoms showed few differences across youth and adults. Tic clusters had small associations with clinical characteristics and showed no associations to the presence of coexisting psychiatric conditions. Cluster membership scores did not predict treatment response to CBIT or tic severity reductions. Tic symptoms distinctly cluster with little difference across youth and adults, or coexisting conditions. This study, which is the first to examine tic clusters and response to treatment, suggested that tic symptom profiles respond equally well to CBIT. Clinical trials.gov. identifiers: NCT00218777; NCT00231985.

Keywords: Chronic tic disorders; Cluster analysis; Comprehensive behavioral intervention for tics; Habit reversal training; Tic symptom profiles; Treatment outcome.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Behavior Therapy / methods*
  • Child
  • Cluster Analysis
  • Female
  • Humans
  • Male
  • Severity of Illness Index
  • Tic Disorders* / complications
  • Tics / diagnosis*
  • Tics / psychology
  • Tics / therapy*
  • Tourette Syndrome / complications
  • Tourette Syndrome / diagnosis*
  • Tourette Syndrome / psychology
  • Tourette Syndrome / therapy*
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT00218777
  • ClinicalTrials.gov/NCT00231985