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. 2022 May 16;12(5):650.
doi: 10.3390/brainsci12050650.

The Prevalence and Comorbidity of Tic Disorders and Obsessive-Compulsive Disorder in Chinese School Students Aged 6-16: A National Survey

Junjuan Yan  1 , Hu Deng  2 , Yongming Wang  3 , Xiaolin Wang  4 , Tengteng Fan  5 , Shijie Li  6 , Fang Wen  1 , Liping Yu  1 , Fang Wang  1 , Jingran Liu  1 , Yuanzhen Wu  7 , Yi Zheng  7 , Yonghua Cui  1 , Ying Li  1
Affiliations

The Prevalence and Comorbidity of Tic Disorders and Obsessive-Compulsive Disorder in Chinese School Students Aged 6-16: A National Survey

Junjuan Yan et al. Brain Sci. .

Abstract

Background: Obsessive-compulsive disorder (OCD) and tic disorders (TDs) are closely related and considered to etiologically overlap. Both disorders are characterized by repetitive behaviors. TD and OCD often co-occur. The high comorbidity between OCD and TD individuals suggests that we also need to pay more attention to the homogeneity and heterogeneity between TS and OCD. To date, there has been no systematic nationwide epidemiological survey of the mental health (including tic disorders and obsessive-compulsive disorder) of children and adolescents in China. Methods: A two-stage epidemiological study of psychiatric point prevalence was conducted. We used the multistage cluster stratified random sampling strategy to assess five provinces of China. The Child Behavior Checklist was used to identify behavioral problems among the enrolled students in the first stage. The results from the Mini-International Neuropsychiatric Interview for Children and Adolescents and evaluations from two psychiatrists based on the Diagnostic and Statistical Manual-IV were used to make a diagnosis. Point weighted prevalence for TD and OCD was estimated. We adjusted prevalence estimates with the product of sampling weights and poststratification weights. Standard error values and 95% confidential intervals were generated with Taylor series linearization. Rao−Scott adjusted chi-square (χ2) tests were employed to compare the prevalence estimates of different age and sex groups. Results: In the first stage, 73,992 participants aged 6−16 years old were selected. The prevalence rates of OCD and TDs were 1.37% (95% CI: 1.28−1.45) and 2.46% (95% CI: 2.35−2.57), respectively. The prevalence of OCD was found to be higher in girls (p < 0.001) and higher in boys with transient tic disorder (TTD) (p < 0.001) and Tourette’s syndrome (TS) (p < 0.001). The most common comorbidity of TS was OCD (40.73%), and for OCD, it was TS (11.36%). Conclusions: Our study is the first nationwide survey on the prevalence of TD (2.46%) and OCD (1.37%) in school students aged 6−16 years old in China. The high comorbidity between OCD and TD individuals suggested overlap based on the prevalence dimensions, which might be influenced by age and sex. This result suggested that we also need to pay more attention to the homogeneity and heterogeneity between TS and OCD.

Keywords: China; adolescents; children; obsessive-compulsive disorder; prevalence; tic disorders.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The flowchart for the procedures of this national survey of OCD and TDs (CBCL: Child Behavior Checklist; MINI-Kid: Mini International Neuropsychiatric Interview for Children and Adolescents; OCD: obsessive-compulsive disorder).
Figure 2
Figure 2
Changes in the prevalence rates of TD and OCD with age (OCD: obsessive-compulsive disorder; TD: tic disorders).
Figure 3
Figure 3
Changes in the prevalence of subtypes of T (TS: Tourette’s syndrome; CMTD: chronic motor tic disorder; CVTD: chronic vocal tic disorder, TTD: transient tic disorder).
Figure 4
Figure 4
The comorbidities of TD (A), TS (C), and OCD (%) (B) (ADHD: attention-deficit/hyperactivity disorder; OCD: obsessive-compulsive disorder; TS: Tourette’s syndrome; CVTD: chronic vocal tic disorder; MDD: major depressive disorder; CMTD: chronic motor tic disorder; ODD: oppositional defiant disorder; GAD: generalized anxiety disorder).
See this image and copyright information in PMC

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