The associations between the heterogeneity of behavioral disinhibition symptoms and quality of life in children with Tourette syndrome

Abstract The presentation of behavioral disinhibition symptoms in children with Tourette syndrome (TS) is highly heterogeneous, with varying degrees of impact on their quality of life (QoL). The objective of this study was to investigate the relationship between behavioral disinhibition symptoms and QoL in subgroups of children with TS. A total of 3,958 children (male/female = 3,004/954, age mean ± SD = 8.65 ± 2.17 years) were included. They were assessed for behavioral disinhibition through the symptoms of TS, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD). Initially, this study employed the latent profile analysis to classify individuals into different latent subgroups (profiles) based on disinhibition symptoms. Subsequently, for each profile, network analysis was performed to construct network structures of disinhibition symptoms and QoL, with the goal of identifying central and bridge symptoms within the network structure. Heterogeneity of behavioral disinhibition symptoms in children with TS was identified, resulting in three latent subgroups: profile 1: low (TS, OCD) + low (ADHD, ODD), profile 2: moderate (TS, OCD) + high (ADHD, ODD), and profile 3: high (TS, OCD) + moderate (ADHD, ODD). Network analyses revealed “psychological” and “inattentive symptoms” as central and bridge symptoms across all profiles. Unique central symptoms related to QoL were “physical and activities of daily living” for profile 1, “family” for profile 2, and “school and learning” for profile 3. The identification of common and unique central and bridge symptoms across all profiles provides new ideas for the development of personalized intervention targets.