title: Suicidal ideation in youth with tic disorders.
abstract: This study examined the incidence and clinical correlates of suicidal ideation (SI) in youth with tic disorders (TD). The independent contribution of tics, anxiety, depressive and externalizing symptoms on SI severity in youth with TD was assessed.
  
  
  
  Participants were 75 treatment-seeking youth with a TD (N=75) aged 6-18. Participants completed diagnostic assessments, clinician-ratings, self- and parent-report measures of emotional functioning and the presence and/or severity of suicidal ideation.
  
  
  
  Based on youth-report, 61% of youth endorsed at least some symptoms of SI, and 8% endorsed symptoms that exceeded the clinically significant cut-off. Parents reported SI in 11% of cases, with generally poor agreement between parent- and youth-report. Suicidal ideation correlated with higher anxiety, depressive and externalizing symptoms, affective lability, and with poorer distress tolerance and overall functioning. Anxiety, depressive and externalizing symptoms showed an independent relationship with SI. Tic severity was not associated with SI. Rather, higher tic severity was associated with an increase in anxiety symptoms, which in turn, was associated with greater SI severity.
  
  
  
  Cross-sectional data limits causal conclusions. Diagnosis was based on unstructured assessments by expert clinicians, including consensus diagnosis, rather than structured clinical interviews.
  
  
  
  Around 8-11% of youth with TD experienced SI. Tic severity did not have any direct influence on SI, however the presence of comorbid anxiety and depressive symptoms significantly increases this risk. Results suggest that it is psychiatric comorbidity, rather than tics themselves, that predispose youth with tic disorders to increased risk of suicidality.
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: carly.johnco@mq.edu.au.
authors.forename: Carly
authors.initials: C
authors.lastname: Johnco
authors.affiliation: Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: McGuire
authors.affiliation: Department of Pediatrics, University of South Florida, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: McBride
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA; All Children's Hospital - Johns Hopkins Medicine, St Petersburg, FL, USA.
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Murphy
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA; Department of Psychology, University of South Florida, USA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Lewin
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA; All Children's Hospital - Johns Hopkins Medicine, St Petersburg, FL, USA; Department of Psychology, University of South Florida, USA; Department of Health Policy and Management, University of South Florida, USA; Rogers Behavioral Health - Tampa Bay, Tampa, FL, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D059020:Suicidal Ideation; D013981:Tic Disorders / Q000523:psychology*
keywords: Adolescents; Anxiety; Children; Depression; Suicidal ideation; Tourette's syndrome