Clinical characteristics and pharmacotherapy choices in children newly diagnosed with tic disorders in China: a retrospective cohort study.

Objective: This study aims to characterise the clinical profiles and pharmacotherapeutic choices among children with newly diagnosed tic disorders (TDs) in China in order to improve clinical understanding and support decision-making for clinicians.

Methods: This was a retrospective cohort study involving 15 182 paediatric patients aged 4-18 years newly diagnosed with TD at Wuhan Children's Hospital between January 2021 and October 2024. Demographic characteristics and initial pharmacotherapy choices were collected and analysed. Clinical characteristics were compared across age (<6 years, 6-12 years and ≥12 years) and gender groups using χ² tests/Wilcoxon rank-sum tests and trend analyses. A generalised linear model was applied to analyse the trend in the male-to-female ratio with increasing age. Pharmacotherapy choices were also analysed and divided into monotherapy and combination therapy for further evaluation.

Results: Among the patients, 78.6%, 9.9% and 11.5% were diagnosed with provisional TD, chronic TD (CTD) and Tourette syndrome (TS), respectively. The median age at diagnosis was 7.3 years, with a male-to-female ratio of 3.7:1. The most common symptom was eye blinking/eye rolling. The rate of premonitory urge and the tic-related impact tended to increase with age. Male patients showed a higher prevalence of CTD and TS, as well as a greater comorbidity rate of attention-deficit/hyperactivity disorder. And the rate of male patients was slightly positively correlated with age at onset. Most patients chose the monotherapy for the first time. Among them, the clonidine patch and traditional Chinese medicine were the most common choices.

Conclusions: We described the clinical phenotypes of paediatric patients with newly diagnosed TD in China. At the same time, we also explored the differences in TD subtypes, clinical characteristics and medication choices between patients in different age and gender groups, providing valuable real-world evidence for an early identification and individualised treatment in paediatric TD.