The COVID-19 pandemic and its impact on tic symptoms in children and young people: a prospective cohort study

Hall, Charlotte L; Marston, Louise; Khan, Kareem; Brown, Beverley J; Sanderson, Charlotte; Andrén, Per; Bennett, Sophie; Heyman, Isobel; Mataix‐Cols, David; Serlachius, Eva; Hollis, Chris; Murphy, Tara

doi:10.1007/s10578-022-01348-1

Cited by 10 publications

(9 citation statements)

References 33 publications

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“… 17 The largest UK tic study utilising pre- and during pandemic tic scores followed 112 (78% male) children with tics who participated in the active control group of a randomised controlled trial (“ORBIT Trial”). 18 , 19 The analysis revealed no difference in tic severity during the pandemic, 20 although the sample was limited to children who were diagnosed with a tic disorder pre-pandemic. Taken together, these findings indicate a mixed, complex picture in which some groups of children and young people may be differentially at greater risk than others of developing tics during the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 92%

Impact of the COVID-19 pandemic on incidence of tics in children and young people: a population-based cohort study

Jack¹,

Joseph²,

Coupland³

et al. 2023

eClinicalMedicine

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Section: Introductionmentioning

confidence: 92%

Impact of the COVID-19 pandemic on incidence of tics in children and young people: a population-based cohort study

Jack¹,

Joseph²,

Coupland³

et al. 2023

eClinicalMedicine

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“…However, the impact of the pandemic on tic severity in adolescents with Tourette Syndrome (TS), and whether impacts are sex specific, is unclear. Previous reports regarding the impact of the pandemic on tic severity from male predominant cohorts that were inclusive of children over a broad age range have been conflicting, with some reporting worsening (5), improvement (6), or no difference (7). A female predominant adult cohort reported 48% of respondents perceived worsening of tics during the pandemic, while 44% reported no change in tic severity (8).…”

Section: Introductionmentioning

confidence: 99%

“…Previous reports regarding the impact of the pandemic on tic severity from male-predominant cohorts that were inclusive of children over a broad age range have been conflicting, with some reporting worsening, 5 improvement, 6 or no difference. 7 A female-predominant adult cohort reported that 48% of respondents perceived worsening of tics during the pandemic, while 44% reported no change in tic severity. 8 Additionally, girls have comprised over 90% of functional tic-like behaviors that have dramatically increased during the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Differences in Tic Severity Among Adolescent Girls and Boys with Tourette Syndrome During the Pandemic

Larsh

Huddleston

et al. 2023

Neuropediatrics

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Objective Limited data is available regarding the impact of the COVID-19 pandemic on adolescents with Tourette Syndrome (TS). We sought to compare sex differences in tic severity experienced by adolescents before and during the COVID-19 pandemic. Methods We extracted from the electronic health record and retrospectively reviewed Yale Global Tic Severity Scores (YGTSS) from adolescents (ages 13 through 17) with TS presenting to our clinic before (36 months) and during (24 months) the pandemic. Results A total of 373 unique adolescent patient encounters (pre-pandemic: 199; pandemic: 173) were identified. Compared to pre-pandemic, girls accounted for a significantly greater proportion of visits during the pandemic (p<0.001). Pre-pandemic, tic severity did not differ between girls and boys. During the pandemic, compared to girls, boys had less clinically severe tics (p=0.003). During the pandemic, older girls, but not boys, had less clinically severe tics (ρ=-0.32, p=0.003). Discussion These findings provide evidence that, regarding tic severity assessed with YGTSS, the experiences of adolescent girls and boys with TS have differed during the pandemic.

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“…The result was not influenced by age or gender or by symptoms of anxiety or ASD. From this, we concluded that COVID‐19 did not significantly impact tics in our sample of children and young people who already had an existing tic disorder (Hall et al., 2022).…”

Section: Discussionmentioning

confidence: 70%

Long‐term clinical and cost‐effectiveness of a therapist‐supported online remote behavioural intervention for tics in children and adolescents: extended 12‐ and 18‐month follow‐up of a single‐blind randomised controlled trial

Hollis

Hall

Khan

et al. 2023

Child Psychology Psychiatry

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Background: Little is known about the long-term effectiveness of behavioural therapy for tics. We aimed to assess the long-term clinical and cost-effectiveness of online therapist-supported exposure and response prevention (ERP) therapy for tics 12 and 18 months after treatment initiation. Methods: ORBIT (online remote behavioural intervention for tics) was a two-arm (1:1 ratio), superiority, single-blind, multicentre randomised controlled trial comparing online ERP for tics with online psychoeducation. The trial was conducted across two Child and Adolescent Mental Health Services in England. Participants were recruited from these two sites, across other clinics in England, or by self-referral. This study was a naturalistic follow-up of participants at 12-and 18-month postrandomisation. Participants were permitted to use alternative treatments recommended by their clinician. The key outcome was the Yale Global Tic Severity Scale Total Tic Severity Score (YGTSS-TTSS). A full economic evaluation was conducted. Registrations are ISRCTN (ISRCTN70758207); ClinicalTrials.gov (NCT03483493). Results: Two hundred and twenty-four participants were enrolled: 112 to ERP and 112 to psychoeducation. The sample was predominately male (177; 79%) and of white ethnicity (195; 87%). The ERP intervention reduced baseline YGTSS-TTSS by 2.64 points (95% CI: À4.48 to À0.79) with an effect size of À0.36 (95% CI: À0.61 to À0.11) after 12 months and by 2.01 points (95% CI: À3.86 to À0.15) with an effect size of À0.27 (95% CI -0.52 to À0.02) after 18 months, compared with psychoeducation. Very few participants (<10%) started new tic treatment during follow-up. The cost difference in ERP compared with psychoeducation was £304.94 (À139.41 to 749.29). At 18 months, the cost per QALY gained was £16,708 for ERP compared with psychoeducation. Conclusions: Remotely delivered online ERP is a clinical and costeffective intervention with durable benefits extending for up to 18 months. This represents an efficient public mental health approach to increase access to behavioural therapy and improve outcomes for tics.

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The COVID-19 pandemic and its impact on tic symptoms in children and young people: a prospective cohort study

Cited by 10 publications

References 33 publications

Impact of the COVID-19 pandemic on incidence of tics in children and young people: a population-based cohort study

Impact of the COVID-19 pandemic on incidence of tics in children and young people: a population-based cohort study

Differences in Tic Severity Among Adolescent Girls and Boys with Tourette Syndrome During the Pandemic

Long‐term clinical and cost‐effectiveness of a therapist‐supported online remote behavioural intervention for tics in children and adolescents: extended 12‐ and 18‐month follow‐up of a single‐blind randomised controlled trial

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