ADHD News & Research

Parents and Doctors Beware: The Hidden Dangers of Chronic Tic Disorders

Research suggests that a child diagnosed with tics or Tourette Syndrome is more likely to entertain suicidal thoughts or act out suicidal behaviors.

October 25, 2016

Children with chronic tic disorders like Tourette Syndrome may be more prone to suicidal thoughts or behaviors than their peers, a new study finds — and the risk goes up as the tics become more severe or if the child is prone to attacks of rage.

The study, which was presented at the 63rd Annual Meeting of the American Academy of Child and Adolescent Psychiatry, looked at 296 children — 196 of whom had a chronic tic disorder or Tourette’s syndrome — with a median age of 12. The children, as well as their parents, participated in structured diagnostic interviews to assess for the presence of suicidal thoughts or behaviors, as well as the severity and duration of the tics.

Among the children with chronic tic disorders, 9.7 percent had experienced suicidal thoughts or behaviors at the time of assessment — compared to just 3 percent of the control group. The difference held up regardless of the child’s age, the researchers said. The severity of the tics had a significant effect on the child’s risk — the worse the tics, the more likely the child experienced suicidal thoughts.

The biggest indicator that a child with chronic tic disorder would experience suicidal thoughts or behaviors, however, was rage: 32 percent of the youth with suicidal thoughts or behavior reported high rates of rage, anger, and frustration. About 25 percent of all children with Tourette Syndrome experience sudden explosive outbursts of anger — more commonly known as “rage attacks” — and this symptom seemed to overlap most with the risk of suicidal behavior, the researchers said.

Tourette Syndrome and chronic tic disorders often co-occur with OCD or anxiety, and the researchers expected those traits to play a part in the risk of suicidal behaviors. To their surprise, however, the link was less clear. “It is really more aggression,” said Joseph McGuire, Ph.D., a clinical instructor at the Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles, the lead author of the study. “It’s a bit more of those impulsive or explosive behaviors,” as opposed to anxiety or OCD symptoms.

Though there’s no data on how many children with chronic tic disorders actually die by suicide, McGuire said, “About 1 in 10 of [these] youth will experience a suicidal thought or behavior.” Doctors need to be on the lookout for these behaviors in children with chronic tic disorder — particularly if the child also experiences rage attacks, impulsive actions, or has a severe level of anxiety.

“When the kid is scoring high on these [measures],” he said, “you want to investigate a bit deeper.”