Time is ticking for TikTok tics: A retrospective follow‐up study in the post‐COVID‐19 isolation era

• Published in: Brain and behavior Vol. 14; no. 3; pp. e3451 - n/a
• Main Authors: Tomczak, Kinga K., Worhach, Jennifer, Rich, Michael, Swearingen Ludolph, Olivia, Eppling, Susan, Sideridis, Georgios, Katz, Tamar C.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.03.2024; John Wiley and Sons Inc; Wiley
• Subjects: Anxiety; Attention deficit hyperactivity disorder; Chi-square test; Children & youth; Comorbidity; Coronaviruses; COVID-19; Extracurricular activities; Families & family life; functional tics; functional tic‐like behaviors; Influencer marketing; Mental disorders; Mental health; Original; Pandemics; Patients; Risk factors; Social networks; Teenagers; tic disorders; Tourette syndrome; functional tics; Tourette syndrome; tic disorders; functional tic-like behaviors
• ISSN: 2162-3279; 2162-3279
• DOI: 10.1002/brb3.3451

Introduction During the COVID‐19 pandemic, an influx of adolescents presented worldwide with acute onset of functional tic‐like behaviors (FTLBs). Our goal was to evaluate psychosocial factors around onset, to elucidate outcomes after pandemic isolation protocols were lifted, and to examine therapy and medication management. Methods A retrospective review was performed of 56 patients ages 10–18 years with new‐onset FTLBs seen at Boston Children's Hospital beginning in March 2020. Demographic factors, medical history, and treatment were evaluated. Patient outcomes were determined retrospectively based on the Clinical Global Impression Improvement (CGI‐I) and Severity (CGI‐S) scales from follow‐up visits. CGI‐I scores assessed the progression of FTLBs; CGI‐S assessed overall function. Results Ninety‐six percent of patients were female‐assigned at birth with high rates of comorbid anxiety (93%) and depression (71%). Forty‐five percent were gender‐diverse. Based on scales that assessed FTLBs (CGI‐I) and overall functioning (CGI‐S), up to 79% of patients improved independent of comorbid diagnosis or treatment. Evidence‐based tic‐specific treatments were not more effective than other treatments. A subset of patients had improvement in their FTLBs but not in their general functioning and continued to have other psychosomatic presentations. Conclusion While many patients’ FTLBs improved, it is critical to remain alert to patients’ overall function and to assess for other functional neurological disorders and mental health concerns. The tendency of FTLBs to improve in this population, independent of treatment, highlights the unique pathophysiology of FTLBs. Future research on contributing psychosocial factors and specific treatment protocols will allow optimal support for these patients.