title: Impact of family environment on the development of tic disorders: epidemiologic evidence for an association.
abstract: BACKGROUND
  Although family education generally is recommended in the treatment of tic disorders, few studies have focused on the relationship between family environment and diagnosis of tic disorders.
  
  
  METHODS
  Presence of DSM-IV tic disorders was determined in a general population of 921 children in Korea from 2008 to 2009. Clinical risk factors were assessed, including comorbidity with attention-deficit/hyperactivity disorder; family-related factors such as the number of family members and primary caretaker of the child; and socioeconomic factors in the form of paternal education level and household yearly income. Multivariable logistic regression analyses were performed to estimate the association between a list of clinical, familial, and social variables and the odds of developing tic disorders.
  
  
  RESULTS
  At Bonferroni corrected thresholds, a higher risk of tic disorders was significantly associated with the number of changes in primary caretaker, whereas a lower risk was associated with increasing number of children in the family.
  
  
  CONCLUSIONS
  Family-related environmental factors may play a role in the development or exacerbation of tic disorders. The results advocate the importance of family education when treating children with tic disorders, and further research is needed on the contextual risk factors of tic disorders.
authors: Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Republic of Korea.
authors: Soon-Beom
authors: SB
authors: Hong
authors: Jae-Won
authors: JW
authors: Kim
authors: Min-Sup
authors: MS
authors: Shin
authors: Yun-Chul
authors: YC
authors: Hong
authors: Eun-Jin
authors: EJ
authors: Park
authors: Boong-Nyun
authors: BN
authors: Kim
authors: Hee-Jeong
authors: HJ
authors: Yoo
authors: In-Hee
authors: IH
authors: Cho
authors: Soo-Young
authors: SY
authors: Bhang
authors: Soo-Churl
authors: SC
authors: Cho
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005191:Family Characteristics; D005195:Family Relations; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011599:Psychopathology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013981:Tic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology