Los tics y su relación con las dificultades de aprendizaje: estudio longitudinal de la prevalencia de los tics primarios y comorbilidad asociada en población escolar
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may 18, 2017
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Resumen
Con el objetivo de estudiar la prevalencia de los trastornos con tics y la asociación con las dificultades de aprendizaje, se realizó un estudio epidemiológico en una muestra de 1.139 escolares. Los resultados señalaron una prevalencia del 16.86% (IC 95% del 14.10 – 19.63). Además se encontraron dificultades académicas en el 11.9% de los escolares, y la presencia de tics en el 8.6%. La presencia de trastornos de tics no se asoció con el bajo rendimiento académico en la cohorte. Los resultados obtenidos fueron contradictorios con relación a otros estudios publicados anteriormente. Como consecuencia de la divergencia en los resultados, se diseña un segundo estudio, que toma como punto de partida el seguimiento longitudinal de la cohorte de los escolares estudiados. En el análisis de regresión de Cox, durante el periodo de seguimiento de 4 años, la repetición de curso se asoció con una menor frecuencia de apoyo psicológico en el centro escolar (HR = 17.5; IC del 95% 5.7 a 53.9) y menor practica de deporte (HR = 4.02, 95% CI 01/03 a 11/08). No se encontró una asociación entre los tics y mayor riesgo de repetir curso.
Keywords
Movement disorders, school difficulties, tics, motor disorders, movement disorders, neurodevelopmental disordersDificultades escolares, trastornos motores, trastornos del movimiento, trastornos del neurodesarrollo, trastornos con tics.
References
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American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
Atladotir, H. O., Partner, E. T., Schendel, D., Dalsgaard, S., Thomsen, P. H., & Thorsen, P. (2007). Time trends in reported diagnoses of childhood neuropsychiatric disorders: a Danish cohort study. The Archives of Pediatrics & Adolescent Medicine, 161(2), 193-8.
Catarina, A., Tavares, S., Figueiroa, S. & Temudo, T. (2007). Tics en niños y adolescentes: análisis retrospectivo de 78 casos. Anales de Pediatría, 66(2), 129-134. Doi:10.1157/13098929.
Comings, D. E. & Comings, B. G. (1987). A controlled study of Tourette syndrome. I. Attention-deficit disorder, learning disorders, and school problems. The American Journal of Humans Genetics, 41, 701-741.
Cubo, E., Gabriel y Galán, JM., Villaverde, VA., Velasco, SS., Benito, VD., … Benito-León, J. (2011). Prevalence of tics in schoolchildren in central Spain: a population-based study. Pediatric Neurology, 45 (2), 100-108 doi: 10.1016/j.pediatrneurol.2011.03.003.
Cubo, E., Trejo, J., Ausín, V., Sáez S, Delgado, V., … Benito-León, J. (2013). Association of tic disorders with poor academic performance in central Spain: a population-based study. Journal of Pediatrics, 163(1), 217-223.e3. doi: 10.1016/j.jpeds.2012.12.030
Díez, A. (2012). Tics en pediatría. Pediatría integral, 16 (10), 795-801.
Eirís-Puñal, J. (2014): Trastornos motores en el trastornos del neurodesarrollo, tics y esterotipias. Revista de Neurología, 58 (1), 77-82.
Elstner, K., Selai, C.E., Trimble, M.R., & Robertson, M.M. (2001). Quality of life (QOL) of patients with Gilles de la Tourette's syndrome. Acta Psychiatrica Scandinavica, 103, 52–59.
Franklin, S.A, Walther, M.R & Woods, D.W. (2010). Behavioral interventions for tic disorders. Psychiatric Clinics of North America, 33, 641-655.
García, R., Perea, E., Romero, J., Rivas, F., Ruiz, C., Oviero, E. & De las Mulas, M. (2008). Spanish adaptation and diagnostic validity of the Yale Global Tics Severity Scale. Revista de Neurología, 46, 261-266.
García-Ribes, A., Martí-Carrera, I., Martínez-González, M.J., Garaizar, C. & Prats-Viñas, J.M. (2003). Factores que influyen en la remisión a corto plazo de los tics en niños con síndrome de Gilles de la Tourette. Revista de Neurología, 37 (10), 901-903.
Kepley, H. O, & Conners, S. (2007) Management of learning and school difficulties in children with Tourette syndrome. In D. W. Woods, J. C. Piacentini & J. T. Walkup, (Eds), Treating Tourette syndrome and tic disorders: a guide for practitioners (pp. 242-264). New York: Guilford Press.
Kurlan, R., Behr, J., Medved, L. & Como, P. (1988). Transient tic disorder and the clinical spectrum of Tourette syndrome. Archives of Neurology, 45, 1200-1201.
Kurlan R, Como G, Miller D, McDemott, MP & Deeley, C. (2002). The behavioural spectrum of tic disorders: a community-based study. Neurology, 59, 414-420.
Kurlan, R., McDermott, M.P., Deeley, C., Como, P.G., Brower, C., … Miller, B. (2001). Prevalence of tics in schoolchildren and association with placement in special education. Neurology, 57, 1383-1388.
Leckman , J.F., Riddle, M.A., Hardin, M.T., Orta, S.I., Swartz, K.L., … & Cohen, D.J. (1989). The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child and Adolescent, 28, 566-573.
Lou, H.C., Henriksen, L. & Bruhn, P. (2005). Striatal dysfunction in attention deficit and hyperkinetic disorder. Archives of General Psychiatric, 52, 393-398.
Melillo, R., & Leisman, G. (2004). Neurobehavioral disorders of childhood: An evolutionary perspective. New York: Kluwer Academic/Plenum Publishers.
Ortiz, B. & Blazicevich, L. (2011). Tics: los trastornos del movimiento más frecuentes en los niños. Iatreia, 4 (23), 386-399.
Packer, L. E. (2005). Tic-related school problems: Impact on functioning, accommodations, and interventions. Behavior Modification, 29, 876-899.
Palumbo, D. Maughan, A., & Kurlan, R. (1997). Tourette syndrome is only one of several causes of a developmental basal ganglia syndrome. Archives of Neurology, 54, 475–483.
Paulson, HL. & Paulson, GW. (2003). Genetics of Pediatric Movement Disorders. Seminars in Pediatric Neurology, 110 (1), 88-95.
Peterson, B. S., Pine, D. S., Cohen, P., & Cook, J. (2001). Prospective, longitudinal study of tic, obsessive-compulsive, and attention-deficit/hyperactivity disorders in an epidemiological sample. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 685-695.
Piacentini, J., & Chang, S. (2001). Behavioral treatments for Tourette syndrome: State of the art. In D. J. Cohen, J. Jankovic, & C. Goetz (Eds.), Advances in neurology: Tourette syndrome (Vol. 85, pp. 319-332). Philadelphia: Lippincott Williams & Wilkins.
Rampello, L., Alvano, A., Battaglia, G., Bruno, V., Raffaele, R. & Nicoletti, F. (2006). Tic disorders: from pathophysiology to treatment. Journal of Neurology, 253(1), 1-15.
Robertson, M. M. (2005). Tourette’s syndrome. Psychiatry, 4, 92-97.
Robertson, M. M. (2000). Tourette syndrome, associated conditions and the complexities of treatment. Brain, 123, 425-462.
Robertson, M. M. (2003). Diagnosing Tourette syndrome: is it a common disorder? Journal of Psychosomatic Research, 55, 3-6
Roessner, V., Plessen, K.J., Rothenberger, A., Ludolph, A.G., Rizzo, R., … Hoekstra, P.J. (2011). European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological. European Child & Adolescent Psychiatry, 20(4), 173-96. doi: 10.1007/s00787-011-0163-7.
Scahill, L., Tanner, C. & Dure, L. (2001). The epidemiology of tics and Tourette syndrome in children and adolescents. Advances in Neurology, 85, 261-271.
Schuerholz, L. J., Baumgardner, T. L., Singer, H. S., Reis, A. L. & Denckla, M. B. (2006). Neuropsychological status of children with Tourette syndrome with and without attention deficit hyperactivity disorder. Neurology, 46, 958-965.
Shannon, K. M. (2005). Trastornos del movimiento. Bradley, WG, Daroff, RB, Fenichel GM, Jankovic, eds. Neurología clínica. Trastornos Neurológicos. Madrid: Elsevier España, SA, 2105-52.
Singer, HS., Schuerholz, LJ. & Denckla, MB. (1995). Learning difficulties in children with Tourette syndrome. Journal of Child Neurology, 10(1), 58-61
Thiebert, A. L., Day, H. I. & Sandor, P. (1995). Self-concepts and self consciousness in adults with Tourette syndrome. Canadian Journal of Psychiatry, 40, 35-39.
Tijero-Merino, B., Gómez-Esteban, J. C. & Zarranz, J. J. (2009). Tics y síndrome de Gilles de la Tourette. Revista de Neurología, 48 (1), 17-20.
Watson, T. S., Dufrene, B., Weaver, A., Butler, T., & Meeks, C. (2005). Brief antecedent assessment and treatment of tics in the general education classroom: a preliminary investigation. Behavior Modification, 29, 839-857.
Zinner, S. H. (2000). Tourette disorder. Pediatrics in Review, 21, 372-82.
Zinner, S. H. (2004). Tourette syndrome-much more than tics, Part 2: Management tailored to the entire patient. Contemporary Pediatrics, 21, 38-49.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
Atladotir, H. O., Partner, E. T., Schendel, D., Dalsgaard, S., Thomsen, P. H., & Thorsen, P. (2007). Time trends in reported diagnoses of childhood neuropsychiatric disorders: a Danish cohort study. The Archives of Pediatrics & Adolescent Medicine, 161(2), 193-8.
Catarina, A., Tavares, S., Figueiroa, S. & Temudo, T. (2007). Tics en niños y adolescentes: análisis retrospectivo de 78 casos. Anales de Pediatría, 66(2), 129-134. Doi:10.1157/13098929.
Comings, D. E. & Comings, B. G. (1987). A controlled study of Tourette syndrome. I. Attention-deficit disorder, learning disorders, and school problems. The American Journal of Humans Genetics, 41, 701-741.
Cubo, E., Gabriel y Galán, JM., Villaverde, VA., Velasco, SS., Benito, VD., … Benito-León, J. (2011). Prevalence of tics in schoolchildren in central Spain: a population-based study. Pediatric Neurology, 45 (2), 100-108 doi: 10.1016/j.pediatrneurol.2011.03.003.
Cubo, E., Trejo, J., Ausín, V., Sáez S, Delgado, V., … Benito-León, J. (2013). Association of tic disorders with poor academic performance in central Spain: a population-based study. Journal of Pediatrics, 163(1), 217-223.e3. doi: 10.1016/j.jpeds.2012.12.030
Díez, A. (2012). Tics en pediatría. Pediatría integral, 16 (10), 795-801.
Eirís-Puñal, J. (2014): Trastornos motores en el trastornos del neurodesarrollo, tics y esterotipias. Revista de Neurología, 58 (1), 77-82.
Elstner, K., Selai, C.E., Trimble, M.R., & Robertson, M.M. (2001). Quality of life (QOL) of patients with Gilles de la Tourette's syndrome. Acta Psychiatrica Scandinavica, 103, 52–59.
Franklin, S.A, Walther, M.R & Woods, D.W. (2010). Behavioral interventions for tic disorders. Psychiatric Clinics of North America, 33, 641-655.
García, R., Perea, E., Romero, J., Rivas, F., Ruiz, C., Oviero, E. & De las Mulas, M. (2008). Spanish adaptation and diagnostic validity of the Yale Global Tics Severity Scale. Revista de Neurología, 46, 261-266.
García-Ribes, A., Martí-Carrera, I., Martínez-González, M.J., Garaizar, C. & Prats-Viñas, J.M. (2003). Factores que influyen en la remisión a corto plazo de los tics en niños con síndrome de Gilles de la Tourette. Revista de Neurología, 37 (10), 901-903.
Kepley, H. O, & Conners, S. (2007) Management of learning and school difficulties in children with Tourette syndrome. In D. W. Woods, J. C. Piacentini & J. T. Walkup, (Eds), Treating Tourette syndrome and tic disorders: a guide for practitioners (pp. 242-264). New York: Guilford Press.
Kurlan, R., Behr, J., Medved, L. & Como, P. (1988). Transient tic disorder and the clinical spectrum of Tourette syndrome. Archives of Neurology, 45, 1200-1201.
Kurlan R, Como G, Miller D, McDemott, MP & Deeley, C. (2002). The behavioural spectrum of tic disorders: a community-based study. Neurology, 59, 414-420.
Kurlan, R., McDermott, M.P., Deeley, C., Como, P.G., Brower, C., … Miller, B. (2001). Prevalence of tics in schoolchildren and association with placement in special education. Neurology, 57, 1383-1388.
Leckman , J.F., Riddle, M.A., Hardin, M.T., Orta, S.I., Swartz, K.L., … & Cohen, D.J. (1989). The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child and Adolescent, 28, 566-573.
Lou, H.C., Henriksen, L. & Bruhn, P. (2005). Striatal dysfunction in attention deficit and hyperkinetic disorder. Archives of General Psychiatric, 52, 393-398.
Melillo, R., & Leisman, G. (2004). Neurobehavioral disorders of childhood: An evolutionary perspective. New York: Kluwer Academic/Plenum Publishers.
Ortiz, B. & Blazicevich, L. (2011). Tics: los trastornos del movimiento más frecuentes en los niños. Iatreia, 4 (23), 386-399.
Packer, L. E. (2005). Tic-related school problems: Impact on functioning, accommodations, and interventions. Behavior Modification, 29, 876-899.
Palumbo, D. Maughan, A., & Kurlan, R. (1997). Tourette syndrome is only one of several causes of a developmental basal ganglia syndrome. Archives of Neurology, 54, 475–483.
Paulson, HL. & Paulson, GW. (2003). Genetics of Pediatric Movement Disorders. Seminars in Pediatric Neurology, 110 (1), 88-95.
Peterson, B. S., Pine, D. S., Cohen, P., & Cook, J. (2001). Prospective, longitudinal study of tic, obsessive-compulsive, and attention-deficit/hyperactivity disorders in an epidemiological sample. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 685-695.
Piacentini, J., & Chang, S. (2001). Behavioral treatments for Tourette syndrome: State of the art. In D. J. Cohen, J. Jankovic, & C. Goetz (Eds.), Advances in neurology: Tourette syndrome (Vol. 85, pp. 319-332). Philadelphia: Lippincott Williams & Wilkins.
Rampello, L., Alvano, A., Battaglia, G., Bruno, V., Raffaele, R. & Nicoletti, F. (2006). Tic disorders: from pathophysiology to treatment. Journal of Neurology, 253(1), 1-15.
Robertson, M. M. (2005). Tourette’s syndrome. Psychiatry, 4, 92-97.
Robertson, M. M. (2000). Tourette syndrome, associated conditions and the complexities of treatment. Brain, 123, 425-462.
Robertson, M. M. (2003). Diagnosing Tourette syndrome: is it a common disorder? Journal of Psychosomatic Research, 55, 3-6
Roessner, V., Plessen, K.J., Rothenberger, A., Ludolph, A.G., Rizzo, R., … Hoekstra, P.J. (2011). European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological. European Child & Adolescent Psychiatry, 20(4), 173-96. doi: 10.1007/s00787-011-0163-7.
Scahill, L., Tanner, C. & Dure, L. (2001). The epidemiology of tics and Tourette syndrome in children and adolescents. Advances in Neurology, 85, 261-271.
Schuerholz, L. J., Baumgardner, T. L., Singer, H. S., Reis, A. L. & Denckla, M. B. (2006). Neuropsychological status of children with Tourette syndrome with and without attention deficit hyperactivity disorder. Neurology, 46, 958-965.
Shannon, K. M. (2005). Trastornos del movimiento. Bradley, WG, Daroff, RB, Fenichel GM, Jankovic, eds. Neurología clínica. Trastornos Neurológicos. Madrid: Elsevier España, SA, 2105-52.
Singer, HS., Schuerholz, LJ. & Denckla, MB. (1995). Learning difficulties in children with Tourette syndrome. Journal of Child Neurology, 10(1), 58-61
Thiebert, A. L., Day, H. I. & Sandor, P. (1995). Self-concepts and self consciousness in adults with Tourette syndrome. Canadian Journal of Psychiatry, 40, 35-39.
Tijero-Merino, B., Gómez-Esteban, J. C. & Zarranz, J. J. (2009). Tics y síndrome de Gilles de la Tourette. Revista de Neurología, 48 (1), 17-20.
Watson, T. S., Dufrene, B., Weaver, A., Butler, T., & Meeks, C. (2005). Brief antecedent assessment and treatment of tics in the general education classroom: a preliminary investigation. Behavior Modification, 29, 839-857.
Zinner, S. H. (2000). Tourette disorder. Pediatrics in Review, 21, 372-82.
Zinner, S. H. (2004). Tourette syndrome-much more than tics, Part 2: Management tailored to the entire patient. Contemporary Pediatrics, 21, 38-49.
Cómo citar
Cubo Delgado, E., González Deza, C., & De la Fuente Anuncibay, R. (2017). Los tics y su relación con las dificultades de aprendizaje: estudio longitudinal de la prevalencia de los tics primarios y comorbilidad asociada en población escolar. Universitas Psychologica, 15(5). https://doi.org/10.11144/Javeriana.upsy15-5.trda
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