A COMPARISON OF THE CHARACTERISTICS OF CHILDREN WITH TOURETTE AND CHRONIC TIC DISORDER ACCORDING TO THEIR BIRTH ORDERS

뚜렛 및 만성 틱 아동의 출생순위에 따른 특성 비교

We studied the clinical characteristics of 45 children with tic symptoms, and a comparison was made according to their birth order patterns. The results were as follows. Sex ration was 14:1 higher for boys. The eldest children were 46.7%, single children, 15.6%, the youngest children, 33.3%, and twins 4.4% of all Organicity was suggested in 37.8%, early developmental problems in 71.1%, and family problems were in 89.9%. Among the co-existing problems, ADHD 46.7%, OCD 17.7%, Separation anxiety disorder 24.4%, GAD or anxiety dreams 17.8%, somatization disorder and enuresis 13.3% each, stuttering 8.9%, and other conditions. Overall, 84.4% of the patients have one or more co-existing conditions other than tic symptoms. When compared according to birth order patterns, the most significant difference was the time of onset The youngests have more incidences around the entrance period for elementary school(p<0.01). Among the twins, the lower birth-weight child was the patient. Summing up these findings, we concluded there were significant environmental factors working on the manifestation of tic and tourette disorders.

45명의 틱 증상을 보인 아동들의 임상적 양상을 검토하였고 형제순위별로 나눠 비교하였다. 성비는 14:1로 남자가 압도적으로 많았고 형제순위로는 맏이가 46.7%, 막내가 33.3%. 외동아 15.6%, 쌍생아 4.4%로 맏이가 많았다. 기질성 시사소견은 37.8%에서, 초기발달 이상은 71.1%, 가족관계의 이상이 89.9%에서 보였고 동반 증상들로는 주의력결핍 과잉운동장애 46.7%, 강박장애 17.7%, 격려불안은 24.4%, 범불안, 수면불안은 17.8%, 신체화 증상 및 아뇨가 각각 13.3%, 말더듬 8.9% 외에 분뇨, 우울증 등을 보여 총 84.4%에서 최소한 하나 이상의 동반된 문제를 가졌다. 형제별로 나눠 특징을 비교했을 때 발병 시기에서 현저한 차이를 보였는데 막내 유형은 입학과 연관된 시기에 발병율이 의미있게 높았다.(p<0.01) 쌍생아의 경우는 저 출생체중아가 환아였다. 이들 소견을 종합해볼 때 틱 및 뚜렛 장애의 발현에는 선천적 기질적 요인뿐 아니라 상당한 환경적인 요인이 작용한다고 보겠다.