J Korean Acad Child Adolesc Psychiatry.  2023 Oct;34(4):236-241. 10.5765/jkacap.230034.

Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice

• Sung Y
• Hong SB

• KMID: 2546909
• DOI: http://doi.org/10.5765/jkacap.230034

Abstract

Objectives
According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice.
Methods
Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette’s syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette’s syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student’s t-tests, and chi-squared tests.
Results
Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027).
Conclusion
Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.

Keyword

Tic disorders; Tourette syndrome; ICD-10; Diagnostic errors