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Clinical precursors of tics: an EMTICS study

Research output: Contribution to journalJournal articlepeer-review


  1. An observational study of emotion regulation in children with Tourette syndrome

    Research output: Contribution to journalJournal articlepeer-review

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  3. Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence

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  4. Psychotic experiences are associated with health anxiety and functional somatic symptoms in preadolescence

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BACKGROUND: Children with Tourette syndrome (TS) often have comorbid disorders, particularly attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). While subtle premorbid symptoms have been described in various psychiatric disorders, the presence of clinical precursors that may exist before the onset of tics is unknown. This longitudinal study aimed to find clinical precursors of tics by assessing a range of clinical characteristics prior to tic onset in comparison with children without onset of tics.

METHODS: A sample of 187 3- to 10-year-old first-degree unaffected relatives of children with TS were followed up to 7 years in the European Multicentre Tics in Children Study (EMTICS). We investigated whether clinical characteristics assessed at baseline predicted tic onset, comparing 126 children without tic onset to 61 children who developed tics. We used the least absolute shrinkage and selection operator (LASSO) method, a penalised logistic regression approach. We also explored sex differences and repeated our analyses in an age- and sex-matched subsample.

RESULTS: Children with tic onset were more frequently male (β = -0.36), had higher baseline severity of conduct problems (β = 0.23), autism spectrum disorder symptoms (ASD; β = 0.08), compulsions (β = 0.02) and emotional problems (β = 0.03) compared to children without tic onset. Conduct and ASD problems were male-specific predictors, whereas severity of compulsions and oppositional (β = 0.39) and emotional problems were female-specific predictors.

CONCLUSION: This study supports the presence of clinical precursors prior to tic onset and highlights the need of sex-specific monitoring of children at risk of developing tics. This may aid in the earlier detection of tics, particularly in females. We moreover found that tics most often persisted one year after tic onset, in contrast to the common belief that tics are mostly transient.

Original languageEnglish
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Issue number3
Pages (from-to)305-314
Number of pages10
Publication statusPublished - Mar 2022

    Research areas

  • clinical precursors, Compulsions, conduct problems, sex differences, tic onset

ID: 66790546