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. 2024 Nov 19;14(11):1641-1651.
doi: 10.5498/wjp.v14.i11.1641.

Family functioning mediation in tic severity and quality of life for children with Tourette syndrome

Shu-Jin Hu  1 , Ying Li  1 , Qing-Hao Yang  1 , Kai Yang  1 , Jin-Hyun Jun  1 , Yong-Hua Cui  1 , Tian-Yuan Lei  2
Affiliations

Family functioning mediation in tic severity and quality of life for children with Tourette syndrome

Shu-Jin Hu et al. World J Psychiatry. .

Abstract

Background: Tourette syndrome (TS) is recognized as a neurodevelopmental disorder profoundly influenced by familial factors, particularly family functioning. However, the relationship among family functioning, tic severity, and quality of life in individuals with TS during childhood and adolescence remains unclear. We hypothesized that family functioning plays a role in the association between the severity of TS and quality of life in children.

Aim: To determine the role of family functioning in the relationship between TS severity and quality of life.

Methods: This study enrolled 139 children (male/female = 113/26) with TS. We assessed tic severity using the Yale Global Tic Severity Scale, quality of life via the Tourette Syndrome Quality of Life Scale, and family functioning through the Family Assessment Device. Our analysis focused on correlating these measures and exploring the mediating role of family functioning in the relationship between tic severity and quality of life. Additionally, we examined if this mediating effect varied by gender or the presence of comorbidity.

Results: We found that family communication dysfunction had a significant mediating effect between tic severity and both psychological symptoms (indirect effect: Β = 0.0038, 95% confidence interval: 0.0006-0.0082) as well as physical and activities of daily living impairment (indirect effect: Β = 0.0029, 95% confidence interval: 0.0004-0.0065). For vocal tic severity, this mediation was found to be even more pronounced. Additionally, in male participants and those without attention deficit hyperactivity disorder, the mediating effect of family communication dysfunction was still evident.

Conclusion: Our study highlights the impact of family functioning on the tic severity and the quality of life in children. This relationship is influenced by gender and comorbid conditions like attention deficit hyperactivity disorder.

Keywords: Children and adolescents; Family functioning; Quality of life; Tic severity; Tourette syndrome.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
The mediating effect of family functioning on the relationship between tic severity and quality of life. A: Mediating effect of family functioning on the relationship between total tic severity and psychological symptoms; B: Mediating effect of family functioning on the relationship between total tic severity and physical and activities of daily living impairments; C: Mediating effect of family functioning on the relationship between vocal tic severity and psychological symptoms; D: Mediating effect of family functioning on the relationship between vocal tic severity and physical and activities of daily living impairment. CI: Confidence interval; GTS-QoL: Gilles de la Tourette Syndrome-Quality of Life Scale; YGTSS: Yale Global Tic Severity Scale; FAD: Family Assessment Device; C: Communication; ADL: Activities of daily living. aP < 0.05, bP < 0.01.
Figure 2
Figure 2
The mediating effect of family functioning on the relationship between tic severity and quality of life in males. A: Mediating effect of family functioning on the relationship between total tic severity and physical and activities of daily living impairments; B: Mediating effect of family functioning on the relationship between vocal tic severity and physical and activities of daily living impairments; C: Mediating effect of family functioning on the relationship between vocal tic severity and psychological symptoms. CI: Confidence interval; GTS-QoL: Gilles de la Tourette Syndrome-Quality of Life Scale; YGTSS: Yale Global Tic Severity Scale; FAD: Family Assessment Device; C: Communication; ADL: Activities of daily living. aP < 0.05, bP < 0.01.
Figure 3
Figure 3
The mediating effect of family functioning on the relationship between tic severity and quality of life in children without attention deficit hyperactivity disorder. A: Mediating effect of family functioning on the relationship between total tic severity and psychological symptoms; B: Mediating effect of family functioning on the relationship between vocal tic severity and psychological symptoms. CI: Confidence interval; GTS-QoL: Gilles de la Tourette Syndrome-Quality of Life Scale; YGTSS: Yale Global Tic Severity Scale; FAD: Family Assessment Device; C: Communication; ADL: Activities of daily living. aP < 0.05, bP < 0.01.
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