Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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Association of Pre- and Perinatal Risk Factors With Tourette Syndrome or Chronic Tic Disorders in a Korean School-Age Population

  • Wooseok Choi (Department of Psychiatry, Seoul National University Hospital) ;
  • Soon-beom Hong (Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • Johanna Inhynag Kim (Department of Psychiatry, Hanyang University Medical Center) ;
  • Jung Lee (Integrative Care Hub, Children's Hospital, Seoul National University Hospital) ;
  • Soomin Jang (Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • Yebin D Ahn (Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • You Bin Lim (Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • Sumin Kim (Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • Mee Rim Oh (Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • Bung-Nyun Kim (Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital)
  • Received : 2022.08.11
  • Accepted : 2022.09.07
  • Published : 2023.01.01
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Abstract

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

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