Influence of sex on tic severity and psychiatric comorbidity profile in patients with pediatric tic disorder.

AIM: To investigate sex-related differences in tic severity, tic-related impairments, and psychiatric comorbidities in childhood. METHOD: In this cross-sectional study, tic severity/impairment and demographic factors were collected from 270 children and young people (aged 5-17y, mean 10y 6mo, SD 3y 4mo; 212 males and 58 females) with a tic disorder diagnosis at a specialty clinic. Psychiatric diagnoses and corresponding screening questionnaire scores were collected for attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), major depressive disorder, and anxiety disorders. Logistic regression was used to compare the effect of sex and age on psychiatric comorbid diagnoses. The Mann-Whitney U test and t-tests were used to assess differences in questionnaire score distribution between sexes. RESULTS: Females had more severe motor tics (12.55 vs 10.81, p=0.01) and higher global severity scores (38.79 vs 32.66, p=0.03) on the Yale Global Tic Severity Scale. Females were less likely to be diagnosed with ADHD (odds ratio=0.48, 95% confidence interval=0.26-0.89). No significant sex difference was observed in diagnosis rates or symptom severity scores for anxiety or OCD. Females had significantly higher scores than males on the Children's Depression Inventory, Second Edition. INTERPRETATION: The higher level of motor tic severity and global severity in females further supports the differential natural history of tic disorders in females. Females with tic disorders may be underdiagnosed for ADHD.

Cannabis Use and Internalizing/Externalizing Symptoms in Youth: A Canadian Population-Based Study.

PURPOSE: With the recent legalization of cannabis for nonmedicinal purposes in Canada, it is becoming increasingly important to understand the potential mental health risks that cannabis may present. The objective of this study was to estimate associations between the frequency of cannabis use and the presence of elevated internalizing (e.g., anxiety and depression) and externalizing (e.g., conduct disorder and attention deficit hyperactivity disorder) symptoms within Ontario youth aged 12-17 years. METHODS: The 2014 Ontario Child Health Study included Emotional and Behavioural Scales used to assess internalizing and externalizing symptoms. To assess associations between internalizing/externalizing symptoms and cannabis use, the Ontario Child Health Study-Emotional and Behavioural Scales were dichotomized using the upper quintile (those with the most severe symptoms). Logistic regression was used to estimate odds ratios (ORs) to quantify the association between the frequency of cannabis use and the presence of elevated internalizing and externalizing symptoms. Estimates used a recommended procedure (replicate bootstrap weighting) to address design effects. RESULTS: A significant association between frequent cannabis use and elevated externalizing symptoms was observed with an OR of 2.17 (1.80-2.62) in males and 5.13 (4.24-6.21) in females. Similar significant associations were also observed between frequent cannabis use and elevated internalizing symptoms with an OR of 2.07 (1.74-2.47) in males and an OR of 3.40 (2.73-4.24) in females. These associations were still present after adjusting for age, binge drinking, smoking, and negative/positive parenting. CONCLUSIONS: Cannabis use, especially in females and frequent users, is associated with elevated levels of internalizing and externalizing symptoms.