Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with Aripiprazole

Background/Objectives: Tic disorders are neurodevelopmental conditions often associated with comorbidities like attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Our aims were: (a) in a sample of youth with tic disorders to explore the clinical and psychopathologica...

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Main Authors: Francesca Falcone, Stefano Berloffa, Gianluca Sesso, Antonio Narzisi, Elena Valente, Valentina Viglione, Gabriele Masi, Annarita Milone, Pamela Fantozzi
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/11/12/1459
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author Francesca Falcone
Stefano Berloffa
Gianluca Sesso
Antonio Narzisi
Elena Valente
Valentina Viglione
Gabriele Masi
Annarita Milone
Pamela Fantozzi
author_facet Francesca Falcone
Stefano Berloffa
Gianluca Sesso
Antonio Narzisi
Elena Valente
Valentina Viglione
Gabriele Masi
Annarita Milone
Pamela Fantozzi
author_sort Francesca Falcone
collection DOAJ
description Background/Objectives: Tic disorders are neurodevelopmental conditions often associated with comorbidities like attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Our aims were: (a) in a sample of youth with tic disorders to explore the clinical and psychopathological characteristics of different phenotypes based on the presence of comorbid ADHD and/or ASD and gender; (b) in a subgroup of patients treated with Aripiprazole, to evaluate symptoms variation over time and to identify potential predictors of response. Methods: A total of 95 subjects with tic disorders (age range 6 to 17.9 years, mean 11.1 ± 2.11 years, 80 males) were naturalistically recruited. Questionnaires and semi-structured interviews were administered to assess the symptomatology and investigate the presence of psychiatric comorbidities (Clinic Global Impression-Severity (CGI-S), Children’s Global Assessment Scale (C-GAS), Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale (PUTS), Child Yale–Brown Obsessive Compulsive Scale for Children (CYBOCS), Child Behavior Checklist 6–18 (CBCL 6–18), Conners’ Parent Rating Scale-Revised—short form (CRSR-S), Reactivity Intensity Polarity Stability Questionnaire—youth version (RIPoSt-Y), and Social Communication Questionnaire—lifetime version (SCQ); Autism Diagnostic Observation Scale—second version (ADOS-2) and Autism Diagnostic Interview—revised version (ADI-R) were administered where ASD was suspected). A total of 22 subjects treated with Aripiprazole were reassessed through the use of some of the clinical measures used at baseline. Results: The presence of ADHD was associated with higher externalizing problem scores on the CBCL 6–18, while ASD was linked to higher internalizing problem scores. A positive correlation was found between the ADHD–ASD interaction and increased internalizing symptoms on CBCL 6–18 and higher ADOS-2 scores. Patients treated with Aripiprazole showed significant improvement across all scales during follow-up. ADHD was identified as a negative predictor of reduced tic severity on the YGTSS. Conclusions: Comorbid neurodevelopmental disorders, such as ADHD or ASD, result in worse emotional and behavioral functioning in patients with tic disorders. ADHD–ASD interaction may be linked to more internalizing symptoms and autistic behaviors. Aripiprazole improves overall clinical outcomes, although comorbid ADHD may hinder the reduction of tic symptoms.
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spelling doaj-art-4e138d95ff8b43e1a58826a4b14ec6682025-08-20T02:57:12ZengMDPI AGChildren2227-90672024-11-011112145910.3390/children11121459Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with AripiprazoleFrancesca Falcone0Stefano Berloffa1Gianluca Sesso2Antonio Narzisi3Elena Valente4Valentina Viglione5Gabriele Masi6Annarita Milone7Pamela Fantozzi8Developmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyDevelopmental Psychiatry and Psycopharmacology Unit, IRCCS Stella Maris Foundation, 311 viale del Tirreno, 56018 Pisa, ItalyBackground/Objectives: Tic disorders are neurodevelopmental conditions often associated with comorbidities like attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Our aims were: (a) in a sample of youth with tic disorders to explore the clinical and psychopathological characteristics of different phenotypes based on the presence of comorbid ADHD and/or ASD and gender; (b) in a subgroup of patients treated with Aripiprazole, to evaluate symptoms variation over time and to identify potential predictors of response. Methods: A total of 95 subjects with tic disorders (age range 6 to 17.9 years, mean 11.1 ± 2.11 years, 80 males) were naturalistically recruited. Questionnaires and semi-structured interviews were administered to assess the symptomatology and investigate the presence of psychiatric comorbidities (Clinic Global Impression-Severity (CGI-S), Children’s Global Assessment Scale (C-GAS), Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale (PUTS), Child Yale–Brown Obsessive Compulsive Scale for Children (CYBOCS), Child Behavior Checklist 6–18 (CBCL 6–18), Conners’ Parent Rating Scale-Revised—short form (CRSR-S), Reactivity Intensity Polarity Stability Questionnaire—youth version (RIPoSt-Y), and Social Communication Questionnaire—lifetime version (SCQ); Autism Diagnostic Observation Scale—second version (ADOS-2) and Autism Diagnostic Interview—revised version (ADI-R) were administered where ASD was suspected). A total of 22 subjects treated with Aripiprazole were reassessed through the use of some of the clinical measures used at baseline. Results: The presence of ADHD was associated with higher externalizing problem scores on the CBCL 6–18, while ASD was linked to higher internalizing problem scores. A positive correlation was found between the ADHD–ASD interaction and increased internalizing symptoms on CBCL 6–18 and higher ADOS-2 scores. Patients treated with Aripiprazole showed significant improvement across all scales during follow-up. ADHD was identified as a negative predictor of reduced tic severity on the YGTSS. Conclusions: Comorbid neurodevelopmental disorders, such as ADHD or ASD, result in worse emotional and behavioral functioning in patients with tic disorders. ADHD–ASD interaction may be linked to more internalizing symptoms and autistic behaviors. Aripiprazole improves overall clinical outcomes, although comorbid ADHD may hinder the reduction of tic symptoms.https://www.mdpi.com/2227-9067/11/12/1459tic disordersattention deficit hyperactivity disorderautism spectrum disorderAripiprazole
spellingShingle Francesca Falcone
Stefano Berloffa
Gianluca Sesso
Antonio Narzisi
Elena Valente
Valentina Viglione
Gabriele Masi
Annarita Milone
Pamela Fantozzi
Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with Aripiprazole
Children
tic disorders
attention deficit hyperactivity disorder
autism spectrum disorder
Aripiprazole
title Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with Aripiprazole
title_full Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with Aripiprazole
title_fullStr Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with Aripiprazole
title_full_unstemmed Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with Aripiprazole
title_short Chronic Tic Disorders in Youth: Clinical Phenotypes and Response to Pharmacological Treatment with Aripiprazole
title_sort chronic tic disorders in youth clinical phenotypes and response to pharmacological treatment with aripiprazole
topic tic disorders
attention deficit hyperactivity disorder
autism spectrum disorder
Aripiprazole
url https://www.mdpi.com/2227-9067/11/12/1459
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