SUICIDAL THOUGHTS AND BEHAVIORS IN CHILDREN AND ADOLESCENTS WITH CHRONIC TIC DISORDERS
Corresponding Author
Eric A. Storch Ph.D.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Department of Psychiatry & Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida
Department of Health Policy and Management, University of South Florida, St. Petersburg, Florida
Rogers Behavioral Health, Tampa Bay, Tampa, Florida
Department of Psychiatry and Psychology, All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida
Correspondence to: Eric A. Storch, Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL 33701. E-mail: [email protected]Search for more papers by this authorCamille E. Hanks B.A.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Search for more papers by this authorJonathan W. Mink M.D.
Department of Neurology, University of Rochester, Rochester, New York
Department of Pediatrics, University of Rochester, Rochester, New York
Department of Neurobiology & Anatomy, University of Rochester, Rochester, New York
Department of Brain & Cognitive Sciences, University of Rochester, Rochester, New York
Search for more papers by this authorJoseph F. McGuire M.A.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Search for more papers by this authorHeather R. Adams Ph.D.
Department of Neurology, University of Rochester, Rochester, New York
Search for more papers by this authorErika F. Augustine M.D.
Department of Neurology, University of Rochester, Rochester, New York
Department of Pediatrics, University of Rochester, Rochester, New York
Search for more papers by this authorAmy Vierhile M.S.N., P.N.P.
Department of Neurology, University of Rochester, Rochester, New York
Search for more papers by this authorAlyssa Thatcher B.S.
Department of Neurology, University of Rochester, Rochester, New York
Search for more papers by this authorRebecca Bitsko Ph.D.
Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Search for more papers by this authorAdam B. Lewin Ph.D.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Department of Psychiatry & Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida
Search for more papers by this authorTanya K. Murphy M.D.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Department of Psychiatry & Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida
Department of Psychiatry and Psychology, All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida
Search for more papers by this authorCorresponding Author
Eric A. Storch Ph.D.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Department of Psychiatry & Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida
Department of Health Policy and Management, University of South Florida, St. Petersburg, Florida
Rogers Behavioral Health, Tampa Bay, Tampa, Florida
Department of Psychiatry and Psychology, All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida
Correspondence to: Eric A. Storch, Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, Box 7523, 880 6th Street South, St. Petersburg, FL 33701. E-mail: [email protected]Search for more papers by this authorCamille E. Hanks B.A.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Search for more papers by this authorJonathan W. Mink M.D.
Department of Neurology, University of Rochester, Rochester, New York
Department of Pediatrics, University of Rochester, Rochester, New York
Department of Neurobiology & Anatomy, University of Rochester, Rochester, New York
Department of Brain & Cognitive Sciences, University of Rochester, Rochester, New York
Search for more papers by this authorJoseph F. McGuire M.A.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Search for more papers by this authorHeather R. Adams Ph.D.
Department of Neurology, University of Rochester, Rochester, New York
Search for more papers by this authorErika F. Augustine M.D.
Department of Neurology, University of Rochester, Rochester, New York
Department of Pediatrics, University of Rochester, Rochester, New York
Search for more papers by this authorAmy Vierhile M.S.N., P.N.P.
Department of Neurology, University of Rochester, Rochester, New York
Search for more papers by this authorAlyssa Thatcher B.S.
Department of Neurology, University of Rochester, Rochester, New York
Search for more papers by this authorRebecca Bitsko Ph.D.
Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Search for more papers by this authorAdam B. Lewin Ph.D.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Department of Psychiatry & Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida
Search for more papers by this authorTanya K. Murphy M.D.
Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
Department of Psychiatry & Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida
Department of Psychiatry and Psychology, All Children's Hospital, Johns Hopkins Medicine, St. Petersburg, Florida
Search for more papers by this authorContract grant sponsor: Centers for Disease Control and Prevention; Contract grant number: U01DD000509-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control.
Abstract
Objective
Despite evidence of elevated risk factors for suicidal thoughts and behavior in youth with Tourette syndrome and chronic tic disorders (CTD), few studies have actually examined that relationship. This study documented the frequency and clinical correlates of suicidal thoughts and behaviors in a sample of children and adolescents with CTD (N = 196, range 6–18 years old). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control.
Method
Youth and parents completed a battery of measures that assessed co-occurring psychiatric diagnoses, child emotional and behavioral symptoms, and impairment due to tics or co-occurring conditions.
Results
A structured diagnostic interview identified that 19 youths with CTD (9.7%) experienced suicidal thoughts and/or behaviors, which was elevated compared to 3 youths (3%) who experienced these thoughts in a community control sample (N = 100, range 6–18 years old, P = .03). For youth with CTD, suicidal thoughts and behaviors were frequently endorsed in the context of anger and frustration. The Child Behavior Checklist (CBCL) anxious/depressed, withdrawn, social problems, thought problems, and aggressive behavior subscales, as well as the total internalizing problems scale, were associated with the presence of suicidal thoughts and/or behaviors. Suicidal thoughts and/or behaviors were significantly associated with tic symptom severity; tic-related impairment; and obsessive–compulsive, depressive, anxiety, and attention-deficit/hyperactivity disorders’ symptom severity. CBCL anxiety/depression scores mediated the relationship between tic severity and suicidal thoughts and behaviors.
Conclusions
Findings suggest that about 1 in 10 youth with CTD experience suicidal thoughts and/or behaviors, which are associated with a more complex clinical presentation and often occur in the presence of anger and frustration.
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