{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:06:58Z","timestamp":1790960818352,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>During the COVID\u201019 pandemic, an influx of adolescents presented worldwide with acute onset of functional tic\u2010like behaviors (FTLBs). Our goal was to evaluate psychosocial factors around onset, to elucidate outcomes after pandemic isolation protocols were lifted, and to examine therapy and medication management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed of 56 patients ages 10\u201318 years with new\u2010onset FTLBs seen at Boston Children's Hospital beginning in March 2020. Demographic factors, medical history, and treatment were evaluated. Patient outcomes were determined retrospectively based on the Clinical Global Impression Improvement (CGI\u2010I) and Severity (CGI\u2010S) scales from follow\u2010up visits. CGI\u2010I scores assessed the progression of FTLBs; CGI\u2010S assessed overall function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety\u2010six percent of patients were female\u2010assigned at birth with high rates of comorbid anxiety (93%) and depression (71%). Forty\u2010five percent were gender\u2010diverse. Based on scales that assessed FTLBs (CGI\u2010I) and overall functioning (CGI\u2010S), up to 79% of patients improved independent of comorbid diagnosis or treatment. Evidence\u2010based tic\u2010specific treatments were not more effective than other treatments. A subset of patients had improvement in their FTLBs but not in their general functioning and continued to have other psychosomatic presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While many patients\u2019 FTLBs improved, it is critical to remain alert to patients\u2019 overall function and to assess for other functional neurological disorders and mental health concerns. The tendency of FTLBs to improve in this population, independent of treatment, highlights the unique pathophysiology of FTLBs. Future research on contributing psychosocial factors and specific treatment protocols will allow optimal support for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.3451","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T02:25:07Z","timestamp":1710210307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Time is ticking for TikTok tics: A retrospective follow\u2010up study in the post\u2010COVID\u201019 isolation era"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7839-4116","authenticated-orcid":false,"given":"Kinga K.","family":"Tomczak","sequence":"first","affiliation":[{"name":"Tic Disorders and Tourette Syndrome Program, Department of Neurology Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Worhach","sequence":"additional","affiliation":[{"name":"Tic Disorders and Tourette Syndrome Program, Department of Neurology Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rich","sequence":"additional","affiliation":[{"name":"Clinic for Interactive Media and Internet Disorders (CIMAID) and Digital Wellness Lab, Division of Adolescent\/Young Adult Medicine Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Swearingen Ludolph","sequence":"additional","affiliation":[{"name":"Tic Disorders and Tourette Syndrome Program, Department of Neurology Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Eppling","sequence":"additional","affiliation":[{"name":"Occupational Therapy Online OTs, and CBIT Therapy  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Sideridis","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar C.","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"issue":"3","key":"e_1_2_10_3_1","first-page":"144","article-title":"Rapid onset functional tic\u2010like disorder outbreak: A challenging differential diagnosis in the COVID\u201019 pandemic","volume":"31","author":"Amorelli G.","year":"2022","journal-title":"Journal of the Canadian Academy of Child and Adolescent Psychiatry"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o64"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102013\u2010305594"},{"key":"e_1_2_10_6_1","unstructured":"Bartholomew R. 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