The association between tic medication therapy and psychiatric comorbidities among patients with Tourette syndrome: A national population-based study in Taiwan |
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| Affiliation: | 1. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan;2. Division of Pediatric Neurology, Landseed Hospital, Taoyuan, Taiwan;3. School of Public Health, National Defense Medical Center, Taiwanese Injury, Taipei, Taiwan;4. Division of Pediatric Neurology, Chang Gung Children’s Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan;1. Shriners Hospitals for Children–Philadelphia, 3551 North Broad Street, Philadelphia, PA 19140, USA;2. University of South Florida, Tampa, FL, USA;3. Abteilung für Wirbelsäulenchirurgie, Eifelklinik St. Brigida, Kammerbruchstrasse 8, 52152 Simmeranth, Germany;4. Setting Scoliosis Straight Foundation, San Diego, CA, USA;5. New York University Hospital for Joint Diseases, New York, NY, USA;6. Rady Children''s Hospital and Health Center, San Diego, CA, USA;7. Alfred I. duPont Hospital for Children, Wilmington, DE, USA;8. Johns Hopkins University, Baltimore, MD, USA;9. University of Miami, Miami, FL, USA;1. Jinan Maternal and Child Care Hospital, Jianguo xiao jing-san Road No. 2, Jinan 250001, Shandong Province, China;2. Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jing-wu Road No. 324, Jinan 250021, Shandong, China;1. The Alfred Hospital, Melbourne, Vic, Australia;2. The Austin Hospital, Melbourne, Vic, Australia;3. The Alfred Centre, Melbourne, Vic, Australia;4. Monash University, Melbourne, Vic, Australia;1. Sleep Disorders Clinic, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico;2. Research Methodology Department, National Institute of Pediatrics, Mexico City, Mexico;3. Department of Developmental Neurology and Psychiatry, Sleep Disease Center, La Sapienza University, S. Andrea Hospital, Rome, Italy;4. Laboratório de Sistemas Evolutivos e de Engenharia Biomédica – ISR, DBE-IST-UL, Lisboa, Portugal;5. Neurodevelopment Laboratory, National Institute of Pediatrics, Mexico City, Mexico;6. Sleep Laboratory, Sueño Mexico, Medicina y Neurofisiología del Dormir, Mexico City, Mexico;7. Area of Neurosciences, Department of Biology of Reproduction, CBS, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico;8. Sleep Disorders Clinic, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico;9. Laboratory of Cognitive Neurophysiology, National Institute of Rehabilitation, Mexico City, Mexico |
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| Abstract: | BackgroundTourette syndrome (TS) is often comorbid with attention deficit hyperactivity disorder, obsessive–compulsive disorder, and depression. Medications are the main treatment for TS. Relationships between TS medication therapy and psychiatric comorbidities remain unclear. This study explored the impacts of TS medication on the risk of psychiatric comorbidities using a nationally representative sample of TS in Taiwan.MethodsData from National Health Insurance Research Database in Taiwan was used to identify 997,213 children and adolescents aged 6–18 years who had received a diagnosis of TS based on ICD-9-CM codes in 2000–2010. Cox’s proportional hazard regression analysis was conducted to estimate the risk of comorbidities among subjects with and without tic medication therapy.ResultsWe found that in TS patients, a lower risk of psychiatric comorbidities occurred in the tic medication therapy group (p = 0.012) and the crude hazard ratio (HR) was 0.6 (95% confidence interval (CI) = 0.4–0.8, p < 0.001). After adjusting for potential confounders of gender, age, income, level of care, department visited, brain injury, and the number of suicide attempts, the risk of comorbidities was still significantly lower in the tic medication therapy group (adjusted HR = 0.5, 95% CI = 0.3–0.6, p < 0.001).DiscussionOne limitation was that we did not include all mediations used to treat psychiatric comorbidities among TS patients. This study found the effectiveness of TS medications on improving psychiatric comorbidities.ConclusionsCompared to those without medication, medication therapy appears to have a benefit of decreasing the risk of psychiatric comorbidities. Strategies to improve medication regimens should be considered in clinical settings. |
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| Keywords: | Tourette syndrome (TS) Medication therapy Psychiatric comorbidity Treatment outcome Research database |
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