Tics are common in childhood. It is estimated that at least 20 percent of children experience temporary tics, which are thought to disappear within a few months. If the tics have been present for less than a year, clinicians refer to this as a ‘provisional tic disorder’ (formerly called “transient tic disorder’). This is seen as an uncomplicated tic disorder, involving only a few mild and simple tics, which clearly differs from Tourette Syndrome. Researchers in the United States conducted a study among 89 children who developed tics between zero and nine months ago. Twelve months after the first tic, the researchers followed up to see how the children were doing.
From the beginning, it became clear that these children had more complex clinical presentation than anticipated. Most children had clinically significant tics, including vocal and complex tics. Many children also had additional problems, such as attention deficit hyperactivity disorder (ADHD), anxiety disorder, obsessive-compulsive disorder or bedwetting. After twelve months, the tics had improved but were still present when the child was alone.
These results confirm the idea that there are no clearly distinguishable tic disorders. It may, in fact, be an arbitrary tradition to divide tic disorders into provisional and chronic. According to the researchers, we could lump all tic disorders together. For families it is important to know that, on average, recently onset tics improve over time but are not expected to disappear completely. In research, it would be more interesting to find out why tics improve in the first year in many children, rather than why tics start. If this is understood, a treatment could be developed to mimic that process in children with more severe tics.
Summary of: Grossen, S. C., Arbuckle, A. L., Bihun, E. C., Koller, J. M., Song, D. Y., Reiersen, A. M., Schlaggar, B. L., Greene, D. J., & Black, K. J. (2024). We’ve all been wrong about provisional tic disorder. Comprehensive psychiatry, 134, 152510.
