title: Parental mood during pregnancy and post-natally is associated with offspring risk of Tourette syndrome or chronic tics: prospective data from the Avon Longitudinal Study of Parents and Children (ALSPAC).
abstract: Little is known about risk factors for Tourette syndrome (TS) and chronic tic disorders (CT) but maternal psychological morbidity in pregnancy may be associated with TS/CT. We examined whether pre- and post-natal parental anxiety and/or depression are associated with risk of TS/CT in the Avon Longitudinal Study of Parents and Children. We compared self-reported anxiety and depression measures collected prospectively at four time points (18 and 32 weeks prenatally, and 8 weeks and 8 months post-natally) among parents of children who subsequently met criteria for TS/CT at 13 years of age as compared to other children from the cohort. We adjusted for various socioeconomic measures and tested both for time period-specific exposure and chronic exposure using multivariable logistic regression models. 122 children had TS/CT (50 TS, 72 CT) and 5968 children had no tics. In crude analyses, both pre- and post-natal maternal anxiety and depression, but only post-natal paternal depression at 8 months, showed associations with TS/CT. In the final, adjusted multivariable models, chronic maternal anxiety (odds ratio 2.17, 95% CI 1.23, 3.84, p = 0.007) and pre-natal maternal depression (odds ratio 1.86, 95% CI 1.02, 3.39, p = 0.04) showed associations with TS/CT though the latter was consistent with chance (p = 0.07) after adjustment for past maternal depression. We find associations between maternal psychological morbidity pre- and post-natally and risk of future TS/CT in offspring. These associations may reflect either shared genetic susceptibility or a pre-natal exposure. Further work is required to see if these findings can be replicated in larger datasets.
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK. y.ben-shlomo@bristol.ac.uk.
authors.forename: Y
authors.identifier: http://orcid.org/0000-0001-6648-3007
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.affiliation: Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA, USA.|Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA, USA.|Division of Cognitive and Behavioral Neurology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Scharf
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: L L
authors.initials: LL
authors.lastname: Miller
authors.affiliation: Program for Genetics and Epidemiology of Neuropsychiatric Symptoms, Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Mathews
mesh_terms: D000339:Affect; D001007:Anxiety / Q000150:complications; D001008:Anxiety Disorders / Q000523:psychology; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000523:psychology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D020323:Tics / Q000150:complications / Q000453:epidemiology*; D005879:Tourette Syndrome / Q000150:complications / Q000453:epidemiology*
keywords: ALSPAC; Anxiety; Cohort studies; Depression; Risk factors; Tourette syndrome