Factors affecting clinicians' decision as to whether to prescribe psychotropic medications or not in treatment of tic disorders

Abstract

Using clinical data, a retrospective investigation was carried out to elucidate factors and/or symptom severity affecting the clinicians' decision-making as to whether or not psychotropic medications should be prescribed for tic disorders. For this purpose, medical records on a total of 75 patients with tic disorders were collected and scrutinized. Of the total, 36 patients were found to have been given psychotropics on their first visit to our facility. With respect to the total scores of motor tics on the YGTSS, vocal tics on the YGTSS, the GAF score and age, the subjects were divided into two groups one with psychotropic medications prescribed and the other without any psychotropic medication at the first examination and compared by use of t-test. With respect to comorbid neuropsychiatric disorders and the sex, the two groups were compared using Chi square test. To see which one of factors had influenced the treating clinicians' decision to use or not to use psychotropic drugs at the first examination, analyses were made using the logistic regression model with those factors assigned for covariants and the prescription or no-prescription of psychotropic medications for dependent variables. Analyses using a logistic regression model revealed that vocal tics (p<0.01) and age (p<0.05) had significant correlations with the use or non-use of psychotropic drugs. This finding suggested that the severity degree of vocal tics might play the most important role as a factor that affects the clinicians' initial treatment plan with or without psychotropic drugs. And clinicians tend to avoid a drug therapy on younger children.