Objective To determine rates of psychiatric comorbidity in a clinical sample of childhood movement disorders (MDs).
Design Cohort study.
Setting Tertiary children’s hospital MD clinics in Sydney, Australia and London, UK.
Patients Cases were children with tic MDs (n=158) and non-tic MDs (n=102), including 66 children with dystonia. Comparison was made with emergency department controls (n=100), neurology controls with peripheral neuropathy or epilepsy (n=37), and community controls (n=10 438).
Interventions On-line development and well-being assessment which was additionally clinically rated by experienced child psychiatrists.
Main outcome measures Diagnostic schedule and manual of mental disorders-5 criteria for psychiatric diagnoses.
Results Psychiatric comorbidity in the non-tic MD cohort (39.2%) was comparable to the tic cohort (41.8%) (not significant). Psychiatric comorbidity in the non-tic MD cohort was greater than the emergency control group (18%, p<0.0001) and the community cohort (9.5%, p<0.00001), but not the neurology controls (29.7%, p=0.31). Almost half of the patients within the tic cohort with psychiatric comorbidity were receiving medical psychiatric treatment (45.5%) or psychology interventions (43.9%), compared with only 22.5% and 15.0%, respectively, of the non-tic MD cohort with psychiatric comorbidity.
Conclusions Psychiatric comorbidity is common in non-tic MDs such as dystonia. These psychiatric comorbidities appear to be under-recognised and undertreated.
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Funding JB is funded by the Australian Department of Health (Medical Research Future Fund), US National Institutes of Health, Charcot-Marie Tooth Association of Australia, Charcot-Marie Tooth Association (USA), Diabetes Australia, Elizabeth Lottie May Rosenthal Bone Bequest, Perpetual Limited, Humpty Dumpty Foundation. Consultancies: Pharnext SA, Charcot Marie Tooth Association (USA) Advisory Board (Clinical Experts), Research & Innovation Advisory Board, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Competing interests RG and his family are the owners of Youthinmind Limited, which provides no-cost and low-cost measures of child mental health, including the Strengths and Difficulties Questionnaire (SDQ) and development and well-being assessment (DAWBA).
Patient consent for publication Not required.
Ethics approval Ethical approval was received from the institutional review board (11CHW14).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.
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