Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice

• Published in: Journal of the Korean Academy of Child and Adolescent Psychiatry Vol. 34; no. 4; pp. 236 - 244
• Main Authors: Sung, Yeeji, Hong, Soon-Beom
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한소아청소년정신의학회 01.10.2023; Korean Academy of Child and Adolescent Psychiatry; 대한소아청소년 정신의학회
• Subjects: Age; Attention deficit hyperactivity disorder; Chi-square test; Clinical medicine; Males; Medical errors; National health insurance; Original; Psychotropic drugs; Variables; Variance analysis; 정신과학; Diagnostic errors; ICD-10; Tourette syndrome; Tic disorders
• ISSN: 1225-729X; 2233-9183; 2233-9183
• DOI: 10.5765/jkacap.230034

According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.