6.85 DEPRESSION AND ANXIETY IN TOURETTE'S DISORDER: AN INTERNATIONAL PERSPECTIVE

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 55; no. 10; p. S232
• Main Authors: Garcia-Delgar, Blanca, Luber, Maxwell, de Larrechea, Ana, Moyano, Beatriz Beatriz, Redondo, Marina, Morer, Astrid, Nonaka, Maiko, Kano, Yukiko, Coffey, Barbara J.
• Format: Journal Article
• Language: English
• Published: Baltimore Elsevier Inc 01.10.2016; Elsevier BV
• Subjects: Age differences; Anxiety; Anxiety Disorders; Anxiety-Depression; Attention deficit hyperactivity disorder; Chi-square test; Clinical variables; Comorbidity; Cultural factors; Cultural Influences; Depression; Depression (Psychology); Depressive personality disorders; Emotional disorders; Gender differences; Interdisciplinary aspects; International comparisons; Mental disorders; Mental health care; Mood; Obsessive compulsive disorder; Patients; Phenomenology; Regression (Statistics); Regression analysis; Severity; Statistical analysis; Tourette syndrome; New York; Barcelona Spain; United States > US; Tokyo Japan; Japan; Spain
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2016.09.404

Objectives: Few studies have examined the prevalence of mood and anxiety disorders in TD and the impact they may have on patients' overall functioning. The aim of this project was to explore the phenomenology of depression and anxiety in TD from an international perspective. Methods: Demographic and clinical data were collected from four clinical sites: the Interdisciplinary Center for Tourette's, OCD, ADHD and Related Disorders, Buenos Aires (BA); the Icahn School of Medicine at Mount Sinai, New York (NY); the Hospital Clinic, Barcelona (BCN); and the University of Tokyo Hospital, Tokyo (TKY). Comparisons among groups were examined using the chi-square test for categorical variables and analysis of variance (ANOVA) for continuous variables. In order to examine the impact of clinical variables on patients' functioning, simple linear regression analyses were conducted. Variables that showed a statistically significant effect were then entered into a multivariate regression model. Overall functioning was measured with the Global Assessment of Functioning (GAF) scale, and tic severity with the Yale Global Tic Severity Scale. Results: Two hundred nine patients (N=209) were included in the analysis (100 from BA, 65 from NY, 25 from BCN, and 19 from TKY). There were no statistically significant differences in age, gender and tic severity among the sub-samples. Rates of major depressive disorder (MDD) were similar across sites (6 percent BA, 4.6 percent NY, 4 percent BCN, and 5.3 percent TKY), while anxiety disorders were more disparate (68 percent BA, 33.8 percent NY, 4 percent BCN and 0 percent TKY). In univariate analyses, the following variables had a negative impact on patients' functioning: tic severity (β=-.357,p=0.01), ADHD (β=-.362,p 0.01), OCD (β=-.227 p=0.01), anxiety disorders (β =-.159, p= 0.02), and MDD (β=-.218,p= 0.01). When these variables were entered into a multivariate regression model, all continued to show a statistically significant negative association with GAF scores except for anxiety disorders (β =-.058,p=0.34). Conclusions: These data suggest that major depression disorder is a common psychiatric comorbid condition in patients with TD worldwide, and when present, has a negative impact on patients' overall functioning. Disparate results for anxiety disorders suggest that this condition may be more influenced by clinical and cultural factors.