Risk factors for children with tic disorder: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

LU Chen ¹ , HAO Hongwen ² , LIAO Xinting ¹ , WANG Baosheng ¹ , LI Panpan ¹ ,  WU Liqun ²

1. Beijing University of Chinese Medicine, Beijing 100029, P.R.China;
2. Department of Pediatrics, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, P.R.China;

Corresponding author：

WU Liqun, Email: wulq1211@163.com

Keywords：

Tic disorder; Risk factor; Pediatrics; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202109158

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Objective To systematically review the risk factors of tic disorder (TD) in children. Methods Databases including PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, VIP, and WanFang Data were electronically searched to collect observational studies on children with TD from inception to June 29^th 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 32 studies involving 556 560 children were included. The results of meta-analysis showed that the risk factors for TD were as follows: male (OR=2.23, 95%CI 1.08 to 4.61, P=0.03), premature delivery (OR=1.66, 95%CI 1.04 to 2.64, P=0.03), low birth weight (OR=1.27, 95%CI 1.07 to 1.50, P=0.005), history of neonatal jaundice (OR=7.46, 95%CI 1.15 to 48.42, P=0.04), other adverse factors in the perinatal period (OR=2.74, 95%CI 1.89 to 3.98, P<0.000 01), poor eating habits (OR=2.11, 95%CI 1.52 to 2.93, P<0.000 01), long-term viewing of electronic products (OR=2.22, 95%CI 1.31 to 3.75, P=0.003), history of febrile convulsions (OR=2.43, 95%CI 1.21 to 4.86, P=0.01), recurrent respiratory infection (OR=2.63, 95%CI 1.49 to 4.64, P=0.000 8), chronic tonsillitis (OR=2.01, 95%CI 1.31 to 3.09, P=0.001), rhinopathy (OR=1.77, 95%CI 1.35 to 2.31, P<0.000 1), attention deficit hyperactivity disorder (ADHD) (OR=5.32, 95%CI 3.77 to 7.51, P<0.000 01), decreased blood iron content (OR=3.68, 95%CI 1.56 to 8.67, P=0.003), family history of TD (OR=6.33, 95%CI 3.20 to 12.53, P<0.000 01), family history of mental illness (OR=2.39, 95%CI 2.03 to 2.83, P<0.000 01), maternal mental disorder during pregnancy (OR=2.49, 95%CI 1.99 to 3.11, P<0.000 01), alcohol drinking during pregnancy (OR=1.40, 95%CI 1.09 to1.79, P=0.007), smoking or passive smoking during pregnancy (OR=1.84, 95%CI 1.68 to 2.01, P<0.000 01), and corporal punishment (OR=3.57, 95%CI 1.52 to 8.34, P=0.003). Parity (second birth and above) (OR=0.41, 95%CI 0.25 to 0.68, P=0.000 6) was a protective factor for tic disorder. Conclusions Current evidence shows that the incidence of TD is related to gender, family history of mental illness, maternal life habits during pregnancy, perinatal history, chronic respiratory diseases, abnormal trace elements, and strict education methods, etc. Moreover, parity is a protective factor for the occurrence of TD. Due to the limited quantity and quality of included studies, more high-quality studies are required to verify the above conclusions.

Citation： LU Chen, HAO Hongwen, LIAO Xinting, WANG Baosheng, LI Panpan, WU Liqun. Risk factors for children with tic disorder: a systematic review. Chinese Journal of Evidence-Based Medicine, 2021, 21(12): 1407-1415. doi: 10.7507/1672-2531.202109158 Copy

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1. 刘茂昌, 刘智胜. 儿童抽动障碍药物治疗研究现状. 中华实用儿科临床杂志, 2020, 35(12): 948-951.
2. Robertson MM. The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 1:the epidemiological and prevalence studies. J Psychosom Res, 2008, 65(5): 461-472.
3. Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17 524 individuals. J Child Psychol Psychiatry, 2021. DOI: 10.1111/jcpp.13445.
4. Zheng Y, Zheng X. Current state and recent developments of child psychiatry in China. Child Adolesc Psychiatry Ment Health, 2015, 9: 10.
5. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
6. 孙中运, 衣明纪, 冉霓, 等. Tourette综合征发病危险因素的病例对照研究. 临床儿科杂志, 2011, 29(12): 1162-1166.
7. 徐逸珩. 基于文献和临床调查探讨小儿抽动障碍中医辨证论治及相关影响因素分析. 上海: 上海中医药大学, 2019.
8. 李志飞, 汤晶晶, 邹英杰, 等. 儿童抽动症相关因素的研究. 中国妇幼健康研究, 2016, 27(1): 20-22.
9. 李树华, 庞保东, 徐应军, 等. 抽动-秽语综合征危险因素的病例对照研究. 中国儿童保健杂志, 2004, 12(5): 412-414.
10. 杨春松, 张伶俐, 俞丹, 等. 孕期危险因素与儿童抽动障碍关系的配对病例对照研究. 国际精神病学杂志, 2018, 45(5): 867-870.
11. 王宇奇, 王艺潼, 薛承宇. 儿童抽动秽语综合征发病影响因素探讨. 名医, 2020, (8): 82-83.
12. 赵荣香, 罗尧竞, 任丹. 儿童多发性抽动症发病危险因素分析. 中华妇幼临床医学杂志(电子版), 2017, 13(2): 177-182.
13. 高翠琴. 链球菌感染及家庭因素与小儿抽动障碍的关系. 广西医学, 2017, 39(5): 615-617.
14. 黄天然, 陆燕珍, 岑丽婷, 等. 肇庆市100例儿童抽动障碍发病危险因素分析. 中外医学研究, 2021, 19(6): 172-174.
15. 龚敏, 胡建邦, 张剑英, 等. 儿童多发性抽动症的环境心理因素分析. 中国公共卫生管理, 2020, 36(1): 59-62.
16. 杨清. 儿童抽动症与微量元素水平的关系研究. 中国妇幼健康研究, 2016, 27(3): 298-299,302.
17. 阮洋, 莫丽亚, 张聪, 等. 儿童抽动症与微量元素水平的相关性研究. 国际检验医学杂志, 2014, (19): 2691-2692.
18. 李小萍, 李进华, 李杏色, 等. 儿童多发性抽动症相关影响因素的调查分析. 河北医药, 2014, (16): 2531-2533.
19. 余益萍, 田永波, 卢玉龙, 等. 贵州黔南地区7~15岁儿童抽动障碍患病现状及危险因素分析. 中国公共卫生, 2018, 34(3): 346-349.
20. 陈怡, 夏琍群, 马碧涛, 等. 某医院儿童抽动障碍发病因素调查分析. 现代生物医学进展, 2016, 16(20): 3949-3952,3948.
21. 陈秀梅. 多发性抽动症相关因素及中医病因的探讨. 广州: 广州中医药大学, 2009.
22. 赵艳艳. 微量元素和血铅的变化对抽动症患儿的影响分析. 济南: 山东大学, 2017.
23. Cubo E, Hortigüela M, Jorge-Roldan S, et al. Prenatal and perinatal morbidity in children with tic disorders: a mainstream school-based population study in central Spain. Tremor Other Hyperkinet Mov, 2014, 4: 272.
24. Ben-Shlomo Y, Scharf JM, Miller LL, et al. Parental mood during pregnancy and post-natally is associated with offspring risk of Tourette syndrome or chronic tics: prospective data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Eur Child Adolesc Psychiatry, 2016, 25(4): 373-381.
25. Mathews CA, Scharf JM, Miller LL, et al. Association between pre- and perinatal exposures and Tourette syndrome or chronic tic disorder in the ALSPAC cohort. Br J Psychiatry, 2014, 204(1): 40-45.
26. Zhu P, Wu M, Huang P, et al. Children from nuclear families with bad parental relationship could develop tic symptoms. Mol Genet Genomic Med, 2020, 8(7): e1286.
27. Mataix-Cols D, Isomura K, Pérez-Vigil A, et al. Familial risks of Tourette syndrome and chronic tic disorders: a population-based cohort study. JAMA Psychiatry, 2015, 72(8): 787-793.
28. Hesapçıoğlu ST, Tural MK, Kandil S. Sociodemographic/clinical characteristics and risk factors associated with chronic tic disorders. Turk Psikiyatri Derg, 2013, 24(3): 158-167.
29. Whitaker AH, Feldman JF, Lorenz JM, et al. Neonatal head ultrasound abnormalities in preterm infants and adolescent psychiatric disorders. Arch Gen Psychiatry, 2011, 68(7): 742-752.
30. Tu YF, Lin CL, Lin CH, et al. Febrile convulsions increase risk of Tourette syndrome. Seizure, 2014, 23(8): 651-656.
31. Weng WC, Huang HL, Wong LC, et al. Increased risks of tic disorders in children with epilepsy: a nation-wide population-based case-control study in Taiwan. Res Dev Disabil, 2016, 51-52: 173-180.
32. Brander G, Rydell M, Kuja-Halkola R, et al. Perinatal risk factors in Tourette's and chronic tic disorders: a total population sibling comparison study. Mol Psychiatry, 2018, 23(5): 1189-1197.
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Chinese Journal of Evidence-Based Medicine

Risk factors for children with tic disorder: a systematic review

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