Impact of the coronavirus disease (COVID-19) pandemic on incidence of tics in children and young people: a population-based cohort study

Date of Approval
Application Number
Technical Summary

The study aims to describe and compare the incidence of tics in children and young people in primary care before and during the coronavirus (COVID-19) pandemic. Monthly incidence rates of tics before (2015-2019) and during (2020, 2021) the pandemic will be calculated, stratified by age group (4-11 years, 12-18 years) and sex. The characteristics of children and young people with a first tic record in three time periods (2015-2019, 2020, and 2021) will be presented. Monthly incidence rates will be compared according to study period to assess whether the monthly rates were altered during the pandemic.
The study population will include people in CPRD Aurum aged 4-18 years in England with eligible follow-up and a first tic record during the period 01 January 2015 to 31 December 2021. To assess incidence, everyone in the study will need at least one year of practice registration before their first tic record.
The outcome is a first tic record during the study window. Monthly incidence rates will be calculated using the CPRD Aurum denominator data and presented according to age group and sex.
Demographic characteristics (age, sex, ethnicity, deprivation score, practice region) and comorbidities (autism spectrum disorders, attention deficit hyperactivity disorder, self-harm, eating disorders, obsessive compulsive disorder, anxiety, and depression) will be described according to study period of first tic record.
The monthly incidence rates of tics will be compared using Poisson or negative binomial regression, as appropriate. Interactions with study period, age group, and sex will be included in the models to test whether the monthly incidence rate for subgroups was altered during the pandemic years (2020, 2021) compared to pre-pandemic (2015-2019).
The study will help identify areas for future service development and will help healthcare professionals understand who may be most vulnerable to developing tics in response to significant environmental stressors.

Health Outcomes to be Measured

Incidence of tics


Chris Hollis - Chief Investigator - University of Nottingham
Rebecca Joseph - Corresponding Applicant - University of Nottingham
Carol Coupland - Collaborator - University of Nottingham
Charlotte Hall - Collaborator - University of Nottingham
Ruth Jack - Collaborator - University of Nottingham
Yana Vinogradova - Collaborator - University of Nottingham


Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation