Clinical Correlates of Quality of Life in Tourette Syndrome

Department of Neuropsychiatry, The Barberry National Centre for Mental Health, Birmingham, United Kingdom.
Movement Disorders (Impact Factor: 5.68). 03/2011; 26(4):735-8. DOI: 10.1002/mds.23434
Source: PubMed


Tourette syndrome (TS) is a neurodevelopmental disorder involving tics, which is frequently accompanied by comorbid obsessive compulsive (OCD) or attention deficit hyperactivity disorder (ADHD). Individuals with TS often report poor quality of life (QoL) in comparison with the general population. This study investigated the clinical correlates of QoL in young people with TS using a self-report multidimensional QoL measure, and a range of clinical scales used to assess tic severity and the symptoms of anxiety, depression, OCD, ADHD and other emotional and behavioral symptoms. Symptoms of depression, OCD, and ADHD appeared to have a widespread negative impact on QoL, but poorer QoL was not associated with increased tic severity. Greater emotional and behavioral difficulties, including symptoms of OCD, were among the best predictors of poor QoL in young people with TS.

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    • "Despite this assumption, the interplay between tic severity, impairment , and quality of life remains unclear among youth with CTDs. For instance, several reports have identified a modest association between tic severity and quality of life (Storch et al., 2007b; Cutler et al., 2009), whereas others have failed to find a significant relationship (Bernard et al., 2009; Eddy et al., 2011a). This ambiguous relationship is further complicated by research suggesting that cooccurring OCD and ADHD (Eddy et al., 2012), depressive symptoms (Muller-Vahl et al., 2010), negative self-perception (Khalifa et al., 2010; Eddy et al., 2011b), and social deficits (McGuire et al., 2013) can negatively impact quality of life for individuals with CTD. "
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    ABSTRACT: Pharmacological and behavioral interventions have focused on reducing tic severity to alleviate tic-related impairment for youth with chronic tic disorders (CTDs), with no existing intervention focused on the adverse psychosocial consequences of tics. This study examined the preliminary efficacy of a modularized cognitive behavioral intervention ("Living with Tics", LWT) in reducing tic-related impairment and improving quality of life relative to a waitlist control of equal duration. Twenty-four youth (ages 7-17 years) with Tourette Disorder or Chronic Motor Tic Disorder and psychosocial impairment participated. A treatment-blind evaluator conducted all pre- and post-treatment clinician-rated measures. Youth were randomly assigned to receive the LWT intervention (n=12) or a 10-week waitlist (n=12). The LWT intervention consisted of up to 10 weekly sessions targeted at reducing tic-related impairment and developing skills to manage psychosocial consequences of tics. Youth in the LWT condition experienced significantly reduced clinician-rated tic-impairment, and improved child-rated quality of life. Ten youth (83%) in the LWT group were classified as treatment responders compared to four youth in the waitlist condition (33%). Treatment gains were maintained at one-month follow-up. Findings provide preliminary data that the LWT intervention reduces tic-related impairment and improves quality of life for youth with CTDs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 12/2014; 225(3). DOI:10.1016/j.psychres.2014.11.045 · 2.47 Impact Factor
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    • "School-aged children with TS have poorer quality of life compared with the general population (Cutler, Murphy, Gilmour & Heyman, 2009); social, emotional and school functioning are particularly vulnerable . Tic severity and common comorbid difficulties such as attention-deficit/hyperactivity disorder (ADHD) and obsessive–compulsive disorder (OCD) are risk factors for poorer quality of life (Eddy et al., 2011; Storch et al., 2007b). Children and adolescents with TS report 'teasing', bullying or victimisation by peers (Jagger et al., 1982; Shady, Fulton & Champion, 1988; Storch et al., 2007a). "
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    ABSTRACT: Background Tourette syndrome (TS) is a poorly understood condition characterised by motor and vocal tics. It may affect children's social functioning at school. This study examined the impact of a psychoeducational intervention (classroom presentation) from multiple perspectives. Method We used a mixed-methods, multiple case-study design with interviews, focus groups and self-report questionnaires. Four children with TS, their parents, teachers and classmates (n=100) took part. ResultsQuestionnaire data showed an increase in classmates' knowledge and positive attitudes about TS postintervention. Qualitative data revealed two overarching themes: the impact on classmates in terms of enabling prosocial behaviours, and the impact on the child in terms of their embracing having TS. ConclusionA brief psychoeducational intervention enhances knowledge and attitudes of classmates towards children with TS, and improves how children with TS feel about the condition. Further research is needed to evaluate this approach with larger samples of children and to identify mechanisms of change. Key Practitioner Message Clinicians routinely recommend psychoeducational approaches for peers of individuals with Tourette Syndrome (TS) to improve knowledge and attitudes; however, there is little research into the effectiveness of this approach This study found that a classroom presentation about TS improved the knowledge and attitudes of the peers of a small number of children with TS The presentation was well received by peers and appeared to improve the self-confidence of the children with T5 and help them embrace their condition The findings suggest that clinicians should continue to recommend psychoeducation for peers of individuals with IS Further research is needed to evaluate this approach more systematically in a larger sample of children and to explore mechanisms for any changes found
    Child and Adolescent Mental Health 02/2014; 19(1). DOI:10.1111/camh.12000 · 1.44 Impact Factor
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    • "Factors of interest have typically been static historical variables, TS-specific symptomaology, or symptoms of co-occurring psychopathology. Several of these factors have been shown to be predictors or correlates of poor emotional functioning and reduced QoL in TS, including age [17], family history of TS [13], tic severity [14] [17], premonitory urge severity [13], presence of any cooccurring psychopathology [16], depression [16] [17], symptoms of OCD and ADHD [18], and ADHD symptom severity [15]. "
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    ABSTRACT: Tourette Syndrome (TS) is a chronic neuropsychiatric condition that frequently persists into adulthood. Existing research has identified demographic and symptom-level variables associated with psychopathology and poor quality of life in TS. However, behavior patterns associated with enhanced or adaptive psychological and global functioning among adults with TS have yet to be empirically identified. The current study examined whether tic-specific activity restriction is related to emotional functioning and quality of life in adults with TS. Participants were 509 adults from the Tourette Syndrome Impact Survey who completed self-report measures of demographics, tic severity, emotional functioning, quality of life, and tic-related general and social activity restriction. Partial correlations controlling for tic severity indicated that tic-related general and social activity restriction were significantly correlated with lower quality of life and poorer emotional functioning. Hierarchical linear regression models indicated that activity restriction significantly predicted lower quality of life and poorer emotional functioning when controlling for tic severity and demographic variables. Adults who restrict fewer activities due to tics, regardless of tic severity, experience greater quality of life and better emotional functioning. Clinically, adults with chronic tics may benefit from interventions focused on enhancing engagement in valued life activities.
    Comprehensive psychiatry 10/2013; 55(1). DOI:10.1016/j.comppsych.2013.06.009 · 2.25 Impact Factor
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