{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:01:57Z","timestamp":1789480917281,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic tic disorders (CTD) are multifaceted disorders characterized by multiple motor and\/or vocal tics. They are often associated with complex tics including echophenomena, paliphenomena, and coprophenomena as well as psychiatric comorbidities such as attention deficit\/hyperactivity disorder (ADHD) and obsessive\u2010compulsive disorder (OCD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our goal was to uncover the inter\u2010relational structure of CTD and comorbid symptoms in children and adults and to understand changes in symptom structure across development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used network and graph analyses to uncover the structure of association of symptoms in childhood\/adolescence (n\u2009=\u2009529) and adulthood (n\u2009=\u2009503) and how this structure might change from childhood to adulthood, pinpointing core symptoms as a main target for interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis yielded core symptom networks in young and adult patients with CTD including complex tics and tic\u2010related phenomena as well as touching people and objects. Core symptoms in childhood also included ADHD symptoms, whereas core symptoms in adults included symptoms of OCD instead. Interestingly, self\u2010injurious behavior did not play a core role in the young CTD network, but became one of the central symptoms in adults with CDT. In addition, we found strong connections between complex motor and vocal tics as well as echolalia and echopraxia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Next to other complex tics, echophenomena, paliphenomena, and coprophenomena can be regarded core symptoms of CTD. ADHD symptoms are closely related to CTD in childhood, whereas symptoms of OCD and self\u2010injurious behavior are closely associated with CTD in adults. Our results suggest that a differentiation between motor and vocal tics is somewhat arbitrary.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.14167","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:40:00Z","timestamp":1721954400000},"page":"1232-1240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Symptom Network Analysis in a Large Sample of Children and Adults with a Chronic Tic Disorder"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4709-7797","authenticated-orcid":false,"given":"Caroline Garcia","family":"Forlim","sequence":"first","affiliation":[{"name":"Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Center for Environmental Neuroscience Max Planck Institute for Human Development  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3208-2659","authenticated-orcid":false,"given":"Valerie","family":"Brandt","sequence":"additional","affiliation":[{"name":"School of Psychology, Centre for Innovation in Mental Health University of Southampton  Southampton UK"},{"name":"Clinic of Psychiatry, Social Psychiatry and Psychotherapy Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewgeni","family":"Jakubovski","sequence":"additional","affiliation":[{"name":"Clinic of Psychiatry, Social Psychiatry and Psychotherapy Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Ganos","sequence":"additional","affiliation":[{"name":"Movement Disorder Clinic, Edmond J. 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