Vitamin D levels in children and adolescents with chronic tic disorders: a multicentre study

the EMTICS Collaborative Group

doi:10.1007/s00787-021-01757-y

Vitamin D levels in children and adolescents with chronic tic disorders: a multicentre study

the EMTICS Collaborative Group

Department of Psychology

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

This study investigated whether vitamin D is associated with the presence or severity of chronic tic disorders and their psychiatric comorbidities. This cross-sectional study compared serum 25-hydroxyvitamin D [25(OH)D] (ng/ml) levels among three groups: children and adolescents (3–16 years) with CTD (n = 327); first-degree relatives (3–10 years) of individuals with CTD who were assessed for a period of up to 7 years for possible onset of tics and developed tics within this period (n = 31); and first-degree relatives who did not develop tics and were ≥ 10 years old at their last assessment (n = 93). The relationship between 25(OH)D and the presence and severity of tics, as well as comorbid obsessive–compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), were analysed controlling for age, sex, season, centre, latitude, family relatedness, and comorbidities. When comparing the CTD cohort to the unaffected cohort, the observed result was contrary to the one expected: a 10 ng/ml increase in 25(OH)D was associated with higher odds of having CTD (OR 2.08, 95% CI 1.27–3.42, p < 0.01). There was no association between 25(OH)D and tic severity. However, a 10 ng/ml increase in 25(OH)D was associated with lower odds of having comorbid ADHD within the CTD cohort (OR 0.55, 95% CI 0.36–0.84, p = 0.01) and was inversely associated with ADHD symptom severity (β = − 2.52, 95% CI − 4.16–0.88, p < 0.01). In conclusion, lower vitamin D levels were not associated with a higher presence or severity of tics but were associated with the presence and severity of comorbid ADHD in children and adolescents with CTD.

Original language	English
Pages (from-to)	1-12
Number of pages	12
Journal	European Child and Adolescent Psychiatry
Volume	31
Issue number	8
DOIs	https://doi.org/10.1007/s00787-021-01757-y
State	Published - Aug 2022

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Funding

This project has received funding from the European Union’s Seventh Framework Programme for research, technological development, and demonstration under grant agreement no 278367. The EMTICS collaborative group is added at the end of the manuscript. This project has received funding from the European Union’s Seventh Framework Programme for research, technological development, and demonstration under grant agreement no 278367. The EMTICS collaborative group is added at the end of the manuscript. The authors want to thank the children and parents who took part in this study. Thanks also goes to Dr Sreeram Ramagopalan and Dr Giulio Disanto for their help and consultation. This project is part of TransCampus, a joint partnership initiative of Technische Universitaet Dresden and King’s College London. Thanks must also go to the EMTICS collaborative group for their continued commitment to this project and in particular to all colleagues at the various study centres who contributed to data collection and/or management including: Julie E Bruun, Judy Grejsen, Christine L Ommundsen, Mette Rubæk (Capital Region Psychiatry, Copenhagen, Denmark); Stephanie Enghardt (TUD Dresden, Germany); Stefanie Bokemeyer, Christiane Driedger-Garbe, Cornelia Reichert (MHH Hannover, Germany); Jenny Schmalfeld (Lübeck University, Germany); Thomas Duffield (Munich, Germany); Franciska Gergye, Margit Kovacs, Reka Vidomusz (Vadaskert Budapest, Hungary); Miri Carmel, Silvana Fennig, Ella Gev, Nathan Keller, Elena Michaelovsky, Matan Nahon, Chen Regev, Tomer Simcha, Gill Smollan, Avi Weizman (Tel Aviv, Petah-Tikva, Israel); Giuseppe Gagliardi (Bari, Italy); Marco Tallon (Rome, Italy); Paolo Roazzi (Rome, Italy); Els van den Ban, Sebastian F.T.M. de Bruijn, Nicole Driessen, Andreas Lamerz, Marieke Messchendorp, Judith J.G. Rath, Nadine Schalk Deborah Sival, Noor Tromp, Frank Visscher and the Stichting Gilles de la Tourettes (UMCG Groningen, Netherlands); Maria Teresa Cáceres, Fátima Carrillo, Pilar Gómez-Garre, Laura Vargas (Seville, Spain); Maria Gariup (Barcelona Spain); Sara Stöber (Fürstenfeldbruck, Germany); and all who may not have been mentioned. The EMTICS group members are Alan Apter1, Valentina Baglioni2, Juliane Ball3, Noa Benaroya-Milshtein1, Benjamin Bodmer4, Molly Bond28, Emese Bognar5,34, Bianka Burger21, Judith Buse4, Francesco Cardona2, Marta Correa Vela6, Andrea Dietrich29, Nanette M. Debes7, Maria Cristina Ferro8, Carolin Fremer9, Blanca Garcia-Delgar10, Mariangela Gulisano8, Annelieke Hagen11,12, Julie Hagstrøm13, Tammy J. Hedderly14, Isobel Heyman15, Pieter j Hoekstra29, Chaim Huyser11,12, Marcos Madruga-Garrido16, Anna Marotta17, Davide Martino18, Ute-Christiane Meier28,30, Pablo Mir6,26, Natalie Moll32, Astrid Morer10,19,20, Norbert Mueller33, Kirsten Müller-Vahl9, Alexander Münchau22, Peter Nagy5,34, Valeria Neri2, Thaïra J.C. Openneer23, Alessandra Pellico8, Ángela Periañez Vasco6, Kerstin J. Plessen13,24, Cesare Porcelli17, Marina Redondo10, Renata Rizzo8, Veit Roessner4, Daphna Ruhrman1, Jaana M. L. Schnell21, Anette Schrag31, Marcus J Schwarz32, Paola Rosaria Silvestri2, Liselotte Skov7, Tamar Steinberg1, Friederike Tagwerker Gloor3, Zsanett Tarnok5, Jennifer Tübing27, Victoria L. Turner14, Susanne Walitza3, Elif Weidinger21, Martin L. Woods141Child and Adolescent Psychiatry Department, Schneider Children’s Medical Center of Israel, Petah-Tikva. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel;2University La Sapienza of Rome, Department of Human Neurosciences, Rome, Italy;3Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland;4Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany;5Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary;6Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clinica. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Seville, Spain;7Paediatric Department, Herlev University Hospital, Herlev, Denmark;8Child Neuropsychiatry Section, Department of Clinical and Experimental Medicine, School of Medicine, Catania University, Catania, Italy;9Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany;10Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari, Barcelona, Spain;11Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands;12Amsterdam UMC, Department of Child and Adolescent Psychiatry, Amsterdam, The Netherlands;13Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark and University of Copenhagen, Copenhagen, Denmark;14Evelina London Children’s Hospital GSTT, Kings Health Partners AHSC, London, UK;15Great Ormond Street Hospital for Children, and UCL Institute of Child Health, London, UK;16Neuropediatrics. Centro de Pediatría de Sevilla. Hospital Viamed Santa Ángela De la Cruz, Seville, Spain;17Azienda Sanitaria Locale di Bari, Mental Health Department, Child and Adolescent Service of Bari Metropolitan Area, Bari, Italy;18Department of Clinical Neurosciences, Cumming School of Medicine & Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada;19Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain;20Centro de Investigacion en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Spain;21Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany;22Institute of Systems Motor Science, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany;23University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, The Netherlands;24Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne, Lausanne, Switzerland;25Department of Clinical Neuroscience, UCL Institute of Neurology, University College London, London, UK;26Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain;27Department of Neurology, University of Lübeck, Lübeck, Germany;28Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Department of Neuroscience and Trauma, Neuroinflammation and Immunopsychiatry Group, London, UK;29University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, The Netherlands;30Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK;31Department of Clinical Neuroscience, UCL Institute of Neurology, University College London, London, UK;32Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany;33Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany;34Bethesda Children's Hospital, Budapest, Hungary.

Funders	Funder number
14Evelina London Children’s Hospital GSTT
15Great Ormond Street Hospital for Children
18Department of Clinical Neurosciences
20Centro de Investigacion en Red de Salud Mental
25Department of Clinical Neuroscience
31Department of Clinical Neuroscience
34Bethesda Children's Hospital
Adolescent Mental Health Center
Adolescent Service of Bari Metropolitan Area
Cumming School of Medicine & Hotchkiss Brain Institute
Department of Clinical and Experimental Medicine, School of Medicine, Catania University
Franciska Gergye
Giuseppe Gagliardi
Instituto de Biomedicina de Sevilla
Kings Health Partners AHSC
London School of Medicine and Dentistry, Department of Neuroscience
Marco Tallon
Margit Kovacs
Maria Gariup
Maria Teresa Cáceres
Marta Correa Vela6
Mental Health Services
Petah-Tikva
Schneider Children’s Medical Center of Israel
Servicio de Neurología y Neurofisiología Clinica
Stephanie Enghardt
Thomas Duffield
UCL Institute of Child Health
University of Calgary
Queen Mary University of London
King’s College London
Seventh Framework Programme	278367
University Hospitals
King's College London
University College London
UCL Institute of Neurology, University College London
Københavns Universitet
Technische Universität Dresden
Universität zu Lübeck
Tel Aviv University
Instituto de Salud Carlos III
Region Hovedstaden
Medizinischen Hochschule Hannover
Ludwig-Maximilians-Universität München
Universität Zürich
Centro de Investigación Biomédica en Red de Salud Mental
Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

ADHD
OCD
Pediatrics
Tic disorder
Tourette
Vitamin D

Access to Document

10.1007/s00787-021-01757-y

Cite this

@article{1b3f343e71bf49e098ef86d1213ce74e,

title = "Vitamin D levels in children and adolescents with chronic tic disorders: a multicentre study",

abstract = "This study investigated whether vitamin D is associated with the presence or severity of chronic tic disorders and their psychiatric comorbidities. This cross-sectional study compared serum 25-hydroxyvitamin D [25(OH)D] (ng/ml) levels among three groups: children and adolescents (3–16 years) with CTD (n = 327); first-degree relatives (3–10 years) of individuals with CTD who were assessed for a period of up to 7 years for possible onset of tics and developed tics within this period (n = 31); and first-degree relatives who did not develop tics and were ≥ 10 years old at their last assessment (n = 93). The relationship between 25(OH)D and the presence and severity of tics, as well as comorbid obsessive–compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), were analysed controlling for age, sex, season, centre, latitude, family relatedness, and comorbidities. When comparing the CTD cohort to the unaffected cohort, the observed result was contrary to the one expected: a 10 ng/ml increase in 25(OH)D was associated with higher odds of having CTD (OR 2.08, 95\% CI 1.27–3.42, p < 0.01). There was no association between 25(OH)D and tic severity. However, a 10 ng/ml increase in 25(OH)D was associated with lower odds of having comorbid ADHD within the CTD cohort (OR 0.55, 95\% CI 0.36–0.84, p = 0.01) and was inversely associated with ADHD symptom severity (β = − 2.52, 95\% CI − 4.16–0.88, p < 0.01). In conclusion, lower vitamin D levels were not associated with a higher presence or severity of tics but were associated with the presence and severity of comorbid ADHD in children and adolescents with CTD.",

keywords = "ADHD, OCD, Pediatrics, Tic disorder, Tourette, Vitamin D",

author = "\{the EMTICS Collaborative Group\} and Molly Bond and Natalie Moll and Alicia Rosello and Rod Bond and Jaana Schnell and Bianka Burger and Hoekstra, \{Pieter J.\} and Andrea Dietrich and Anette Schrag and Eva Kocovska and Davide Martino and Norbert Mueller and Markus Schwarz and Meier, \{Ute Christiane\} and Bruun, \{Julie E.\} and Judy Grejsen and Ommundsen, \{Christine L.\} and Mette Rub{\ae}k and Stephanie Enghardt and Stefanie Bokemeyer and Christiane Driedger-Garbe and Cornelia Reichert and Jenny Schmalfeld and Thomas Duffield and Franciska Gergye and Margit Kovacs and Reka Vidomusz and Miri Carmel and Silvana Fennig and Ella Gev and Nathan Keller and Elena Michaelovsky and Matan Nahon and Chen Regev and Tomer Simcha and Gill Smollan and Avi Weizman and Giuseppe Gagliardi and Marco Tallon and Paolo Roazzi and \{van den Ban\}, Els and \{de Bruijn\}, \{Sebastian F.T.M.\} and Nicole Driessen and Andreas Lamerz and Marieke Messchendorp and Rath, \{Judith J.G.\} and Sival, \{Nadine Schalk Deborah\} and Noor Tromp and Frank Visscher and Alan Apter",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2022",

month = aug,

doi = "10.1007/s00787-021-01757-y",

language = "אנגלית",

volume = "31",

pages = "1--12",

journal = "European Child and Adolescent Psychiatry",

issn = "1018-8827",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "8",

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TY - JOUR

T1 - Vitamin D levels in children and adolescents with chronic tic disorders

T2 - a multicentre study

AU - the EMTICS Collaborative Group

AU - Bond, Molly

AU - Moll, Natalie

AU - Rosello, Alicia

AU - Bond, Rod

AU - Schnell, Jaana

AU - Burger, Bianka

AU - Hoekstra, Pieter J.

AU - Dietrich, Andrea

AU - Schrag, Anette

AU - Kocovska, Eva

AU - Martino, Davide

AU - Mueller, Norbert

AU - Schwarz, Markus

AU - Meier, Ute Christiane

AU - Bruun, Julie E.

AU - Grejsen, Judy

AU - Ommundsen, Christine L.

AU - Rubæk, Mette

AU - Enghardt, Stephanie

AU - Bokemeyer, Stefanie

AU - Driedger-Garbe, Christiane

AU - Reichert, Cornelia

AU - Schmalfeld, Jenny

AU - Duffield, Thomas

AU - Gergye, Franciska

AU - Kovacs, Margit

AU - Vidomusz, Reka

AU - Carmel, Miri

AU - Fennig, Silvana

AU - Gev, Ella

AU - Keller, Nathan

AU - Michaelovsky, Elena

AU - Nahon, Matan

AU - Regev, Chen

AU - Simcha, Tomer

AU - Smollan, Gill

AU - Weizman, Avi

AU - Gagliardi, Giuseppe

AU - Tallon, Marco

AU - Roazzi, Paolo

AU - van den Ban, Els

AU - de Bruijn, Sebastian F.T.M.

AU - Driessen, Nicole

AU - Lamerz, Andreas

AU - Messchendorp, Marieke

AU - Rath, Judith J.G.

AU - Sival, Nadine Schalk Deborah

AU - Tromp, Noor

AU - Visscher, Frank

AU - Apter, Alan

PY - 2022/8

Y1 - 2022/8

N2 - This study investigated whether vitamin D is associated with the presence or severity of chronic tic disorders and their psychiatric comorbidities. This cross-sectional study compared serum 25-hydroxyvitamin D [25(OH)D] (ng/ml) levels among three groups: children and adolescents (3–16 years) with CTD (n = 327); first-degree relatives (3–10 years) of individuals with CTD who were assessed for a period of up to 7 years for possible onset of tics and developed tics within this period (n = 31); and first-degree relatives who did not develop tics and were ≥ 10 years old at their last assessment (n = 93). The relationship between 25(OH)D and the presence and severity of tics, as well as comorbid obsessive–compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), were analysed controlling for age, sex, season, centre, latitude, family relatedness, and comorbidities. When comparing the CTD cohort to the unaffected cohort, the observed result was contrary to the one expected: a 10 ng/ml increase in 25(OH)D was associated with higher odds of having CTD (OR 2.08, 95% CI 1.27–3.42, p < 0.01). There was no association between 25(OH)D and tic severity. However, a 10 ng/ml increase in 25(OH)D was associated with lower odds of having comorbid ADHD within the CTD cohort (OR 0.55, 95% CI 0.36–0.84, p = 0.01) and was inversely associated with ADHD symptom severity (β = − 2.52, 95% CI − 4.16–0.88, p < 0.01). In conclusion, lower vitamin D levels were not associated with a higher presence or severity of tics but were associated with the presence and severity of comorbid ADHD in children and adolescents with CTD.

AB - This study investigated whether vitamin D is associated with the presence or severity of chronic tic disorders and their psychiatric comorbidities. This cross-sectional study compared serum 25-hydroxyvitamin D [25(OH)D] (ng/ml) levels among three groups: children and adolescents (3–16 years) with CTD (n = 327); first-degree relatives (3–10 years) of individuals with CTD who were assessed for a period of up to 7 years for possible onset of tics and developed tics within this period (n = 31); and first-degree relatives who did not develop tics and were ≥ 10 years old at their last assessment (n = 93). The relationship between 25(OH)D and the presence and severity of tics, as well as comorbid obsessive–compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), were analysed controlling for age, sex, season, centre, latitude, family relatedness, and comorbidities. When comparing the CTD cohort to the unaffected cohort, the observed result was contrary to the one expected: a 10 ng/ml increase in 25(OH)D was associated with higher odds of having CTD (OR 2.08, 95% CI 1.27–3.42, p < 0.01). There was no association between 25(OH)D and tic severity. However, a 10 ng/ml increase in 25(OH)D was associated with lower odds of having comorbid ADHD within the CTD cohort (OR 0.55, 95% CI 0.36–0.84, p = 0.01) and was inversely associated with ADHD symptom severity (β = − 2.52, 95% CI − 4.16–0.88, p < 0.01). In conclusion, lower vitamin D levels were not associated with a higher presence or severity of tics but were associated with the presence and severity of comorbid ADHD in children and adolescents with CTD.

KW - ADHD

KW - OCD

KW - Pediatrics

KW - Tic disorder

KW - Tourette

KW - Vitamin D

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VL - 31

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JO - European Child and Adolescent Psychiatry

JF - European Child and Adolescent Psychiatry

IS - 8

ER -

Vitamin D levels in children and adolescents with chronic tic disorders: a multicentre study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

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