Abstract
OBJECTIVE: To identify risk factors for recurrence in children with chronic tic disorders after 1 year of medication treatment and 6 months post-medication discontinuation. METHODS: A two-phase hybrid design study was conducted at Wuxi Children's Hospital, involving 124 paediatric patients with chronic tic disorders treated between January 2020 and December 2022. After 1 year of medication treatment, patients were categorised into relapse and no relapse groups based on recurrence within 6 months post-medication discontinuation. Clinical data from both groups were compared, and multivariate binary logistic regression analysis was used to determine independent risk factors for recurrence. RESULTS: Significant differences were found between the relapse and no relapse groups in age (p = 0.003), white blood cell count (p = 0.001), Mycoplasma pneumoniae antibody IgM (p = 0.009), tic characteristics (p = 0.025), and medication treatment (p = 0.001). Binary logistic regression analysis identified Mycoplasma pneumoniae antibody IgM (OR = 4.797, 95% CI: 1.826-12.605) and vocal tics (OR = 8.202, 95% CI: 2.751-24.455) as independent risk factors for recurrence. Age (OR = 0.519, 95% CI: 0.335-0.803) and Aripiprazole (OR = 0.091, 95% CI: 0.031-0.271) were identified as protective factors. CONCLUSION: Mycoplasma infection, and vocal tics are significant risk factors for recurrence in children with chronic tic disorders. Increased age and the use of aripiprazole may serve as protective factors and be considered for clinical management of chronic tic disorders in children.