The association between tic medication therapy and psychiatric comorbidities among patients with Tourette syndrome: A national population-based study in Taiwan

Chia Wen Chen, Chang Wei Hsueh, Chi Hsiang Chung, Huei Shyong Wang, Hsiu Ju Chang, Wu Chien Chien

Research output: Contribution to journalArticle

Abstract

Background: Tourette syndrome (TS) is often comorbid with attention deficit hyperactivity disorder, obsessive–compulsive disorder, and depression. Medications are the main treatment for TS. Relationships between TS medication therapy and psychiatric comorbidities remain unclear. This study explored the impacts of TS medication on the risk of psychiatric comorbidities using a nationally representative sample of TS in Taiwan. Methods: Data from National Health Insurance Research Database in Taiwan was used to identify 997,213 children and adolescents aged 6–18 years who had received a diagnosis of TS based on ICD-9-CM codes in 2000–2010. Cox's proportional hazard regression analysis was conducted to estimate the risk of comorbidities among subjects with and without tic medication therapy. Results: We found that in TS patients, a lower risk of psychiatric comorbidities occurred in the tic medication therapy group (p = 0.012) and the crude hazard ratio (HR) was 0.6 (95% confidence interval (CI) = 0.4–0.8, p < 0.001). After adjusting for potential confounders of gender, age, income, level of care, department visited, brain injury, and the number of suicide attempts, the risk of comorbidities was still significantly lower in the tic medication therapy group (adjusted HR = 0.5, 95% CI = 0.3–0.6, p < 0.001). Discussion: One limitation was that we did not include all mediations used to treat psychiatric comorbidities among TS patients. This study found the effectiveness of TS medications on improving psychiatric comorbidities. Conclusions: Compared to those without medication, medication therapy appears to have a benefit of decreasing the risk of psychiatric comorbidities. Strategies to improve medication regimens should be considered in clinical settings.

Original languageEnglish
JournalBrain and Development
DOIs
Publication statusAccepted/In press - Jan 1 2020

Fingerprint

Tics
Tourette Syndrome
Taiwan
Psychiatry
Comorbidity
Population
Therapeutics
Group Psychotherapy
Confidence Intervals
National Health Programs
International Classification of Diseases
Attention Deficit Disorder with Hyperactivity
Brain Injuries
Suicide
Regression Analysis
Databases
Depression

Keywords

  • Medication therapy
  • Psychiatric comorbidity
  • Research database
  • Tourette syndrome (TS)
  • Treatment outcome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

The association between tic medication therapy and psychiatric comorbidities among patients with Tourette syndrome : A national population-based study in Taiwan. / Chen, Chia Wen; Hsueh, Chang Wei; Chung, Chi Hsiang; Wang, Huei Shyong; Chang, Hsiu Ju; Chien, Wu Chien.

In: Brain and Development, 01.01.2020.

Research output: Contribution to journalArticle

@article{d7de07d92070438093a33b9c5a42ba3f,
title = "The association between tic medication therapy and psychiatric comorbidities among patients with Tourette syndrome: A national population-based study in Taiwan",
abstract = "Background: Tourette syndrome (TS) is often comorbid with attention deficit hyperactivity disorder, obsessive–compulsive disorder, and depression. Medications are the main treatment for TS. Relationships between TS medication therapy and psychiatric comorbidities remain unclear. This study explored the impacts of TS medication on the risk of psychiatric comorbidities using a nationally representative sample of TS in Taiwan. Methods: Data from National Health Insurance Research Database in Taiwan was used to identify 997,213 children and adolescents aged 6–18 years who had received a diagnosis of TS based on ICD-9-CM codes in 2000–2010. Cox's proportional hazard regression analysis was conducted to estimate the risk of comorbidities among subjects with and without tic medication therapy. Results: We found that in TS patients, a lower risk of psychiatric comorbidities occurred in the tic medication therapy group (p = 0.012) and the crude hazard ratio (HR) was 0.6 (95{\%} confidence interval (CI) = 0.4–0.8, p < 0.001). After adjusting for potential confounders of gender, age, income, level of care, department visited, brain injury, and the number of suicide attempts, the risk of comorbidities was still significantly lower in the tic medication therapy group (adjusted HR = 0.5, 95{\%} CI = 0.3–0.6, p < 0.001). Discussion: One limitation was that we did not include all mediations used to treat psychiatric comorbidities among TS patients. This study found the effectiveness of TS medications on improving psychiatric comorbidities. Conclusions: Compared to those without medication, medication therapy appears to have a benefit of decreasing the risk of psychiatric comorbidities. Strategies to improve medication regimens should be considered in clinical settings.",
keywords = "Medication therapy, Psychiatric comorbidity, Research database, Tourette syndrome (TS), Treatment outcome",
author = "Chen, {Chia Wen} and Hsueh, {Chang Wei} and Chung, {Chi Hsiang} and Wang, {Huei Shyong} and Chang, {Hsiu Ju} and Chien, {Wu Chien}",
year = "2020",
month = "1",
day = "1",
doi = "10.1016/j.braindev.2020.01.002",
language = "English",
journal = "Brain and Development",
issn = "0387-7604",
publisher = "Elsevier",

}

TY - JOUR

T1 - The association between tic medication therapy and psychiatric comorbidities among patients with Tourette syndrome

T2 - A national population-based study in Taiwan

AU - Chen, Chia Wen

AU - Hsueh, Chang Wei

AU - Chung, Chi Hsiang

AU - Wang, Huei Shyong

AU - Chang, Hsiu Ju

AU - Chien, Wu Chien

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background: Tourette syndrome (TS) is often comorbid with attention deficit hyperactivity disorder, obsessive–compulsive disorder, and depression. Medications are the main treatment for TS. Relationships between TS medication therapy and psychiatric comorbidities remain unclear. This study explored the impacts of TS medication on the risk of psychiatric comorbidities using a nationally representative sample of TS in Taiwan. Methods: Data from National Health Insurance Research Database in Taiwan was used to identify 997,213 children and adolescents aged 6–18 years who had received a diagnosis of TS based on ICD-9-CM codes in 2000–2010. Cox's proportional hazard regression analysis was conducted to estimate the risk of comorbidities among subjects with and without tic medication therapy. Results: We found that in TS patients, a lower risk of psychiatric comorbidities occurred in the tic medication therapy group (p = 0.012) and the crude hazard ratio (HR) was 0.6 (95% confidence interval (CI) = 0.4–0.8, p < 0.001). After adjusting for potential confounders of gender, age, income, level of care, department visited, brain injury, and the number of suicide attempts, the risk of comorbidities was still significantly lower in the tic medication therapy group (adjusted HR = 0.5, 95% CI = 0.3–0.6, p < 0.001). Discussion: One limitation was that we did not include all mediations used to treat psychiatric comorbidities among TS patients. This study found the effectiveness of TS medications on improving psychiatric comorbidities. Conclusions: Compared to those without medication, medication therapy appears to have a benefit of decreasing the risk of psychiatric comorbidities. Strategies to improve medication regimens should be considered in clinical settings.

AB - Background: Tourette syndrome (TS) is often comorbid with attention deficit hyperactivity disorder, obsessive–compulsive disorder, and depression. Medications are the main treatment for TS. Relationships between TS medication therapy and psychiatric comorbidities remain unclear. This study explored the impacts of TS medication on the risk of psychiatric comorbidities using a nationally representative sample of TS in Taiwan. Methods: Data from National Health Insurance Research Database in Taiwan was used to identify 997,213 children and adolescents aged 6–18 years who had received a diagnosis of TS based on ICD-9-CM codes in 2000–2010. Cox's proportional hazard regression analysis was conducted to estimate the risk of comorbidities among subjects with and without tic medication therapy. Results: We found that in TS patients, a lower risk of psychiatric comorbidities occurred in the tic medication therapy group (p = 0.012) and the crude hazard ratio (HR) was 0.6 (95% confidence interval (CI) = 0.4–0.8, p < 0.001). After adjusting for potential confounders of gender, age, income, level of care, department visited, brain injury, and the number of suicide attempts, the risk of comorbidities was still significantly lower in the tic medication therapy group (adjusted HR = 0.5, 95% CI = 0.3–0.6, p < 0.001). Discussion: One limitation was that we did not include all mediations used to treat psychiatric comorbidities among TS patients. This study found the effectiveness of TS medications on improving psychiatric comorbidities. Conclusions: Compared to those without medication, medication therapy appears to have a benefit of decreasing the risk of psychiatric comorbidities. Strategies to improve medication regimens should be considered in clinical settings.

KW - Medication therapy

KW - Psychiatric comorbidity

KW - Research database

KW - Tourette syndrome (TS)

KW - Treatment outcome

UR - http://www.scopus.com/inward/record.url?scp=85078836938&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85078836938&partnerID=8YFLogxK

U2 - 10.1016/j.braindev.2020.01.002

DO - 10.1016/j.braindev.2020.01.002

M3 - Article

AN - SCOPUS:85078836938

JO - Brain and Development

JF - Brain and Development

SN - 0387-7604

ER -