Philadelphia, PA, July 5, 2017 - People with Tourette's disorder or chronic tic disorder are over four times more likely to die by suicide than the general population, according to a new study in Biological Psychiatry. Dr. David Mataix-Cols of Karolinska Institute, Sweden, led the study of the largest group of patients with tic disorders in the world. The study sample included 7,736 patients from the Swedish National Patient Register diagnosed with tic disorders over four decades. Compared with 77,360 people from the general population, the increased risk remained even after taking other psychiatric comorbidities into account, showing that tic disorders are associated with an increased risk of suicide in their own right.
"The results highlight an under-recognized mental health need in people with Tourette's and chronic tic disorders," said first author Dr. Lorena Fernández de la Cruz, also of Karolinska Institute, referring to the scarce attention that suicide in tic disorders has received despite the substantial link between psychiatric illness and death by suicide. The authors hope the alarming risk found in the disorder will contribute to the clinical management of these patients.
Tic disorders typically emerge around 4 to 6 years old and often resolve in young adulthood. But for about 20% of patients, debilitating tics persist into adulthood. In the study, Fernández de la Cruz and colleagues found that a persistent diagnosis of a tic disorder into adulthood was the strongest predictor of suicide risk. A previous suicide attempt was also a strong predictor of death by suicide, and patients with tic disorders were nearly four times more likely to attempt suicide than people in the comparison group.
Although tic disorders affect more boys than girls, the risk of suicide was the same for both sexes. The researchers also assessed the impact on risk of other psychiatric disorders that commonly coincide with tic disorders, and found that comorbid personality disorders increased the risk of suicide by nearly threefold.
"The medical risks of tic spectrum disorders have been downplayed in the media, where individuals with tics may be portrayed in humorous ways. However, suicide is no laughing matter and the study by Fernández de la Cruz is a wake-up call for many about the potential seriousness of tic spectrum disorders," said Dr. John Krystal, Editor of Biological Psychiatry.
"Suicidal behavior should be carefully monitored long-term in these patients," said Fernández de la Cruz. The predictors that emerged in the study will help clinicians identify patients most in need of attention. Fernández de la Cruz added that the results are a first step toward the design of strategies aimed at preventing fatal consequences in patients with Tourette's and chronic tic disorders.
Notes for editorsThe article is "Suicide in Tourette's and Chronic Tic Disorders," by Lorena Fernández de la Cruz, Mina Rydell, Bo Runeson, Gustaf Brander, Christian Rück, Brian M. D'Onofrio, Henrik Larsson, Paul Lichtenstein, and David Mataix-Cols . It appears in Biological Psychiatry, volume 82, issue 2 (July 2017), published by Elsevier.
Copies of this paper are available to credentialed journalists upon request; please contact Rhiannon Bugno at Biol.Psych@UTSouthwestern.edu or +1 214 648 0880. Journalists wishing to interview the authors may contact Lorena Fernández de la Cruz, Ph.D., at email@example.com.
The authors' affiliations and disclosures of financial and conflicts of interests are available in the article.
John H. Krystal, M.D., is Chairman of the Department of Psychiatry at the Yale University School of Medicine, Chief of Psychiatry at Yale-New Haven Hospital, and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here.
About Biological Psychiatry
Biological Psychiatry is the official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders.
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