The rise of functional tic-like behaviors: what do the COVID-19 pandemic and social Media have to do with it? A narrative review
Open accessAbstract
Background There has been a rise in explosive onset of tic-like behaviors during the COVID-19 pandemic. Historically, this is an uncommon phenomenology of functional movement disorders across all ages. Both the psychological burden of the pandemic and social media usage have been implicated in the rise of these tic-like behaviors. Methods This paper provides a narrative review of the literature on chronic tic disorders, functional tics, and mass functional illness with particular focus on the key distinguishing features, role of social media, and the role of COVID-19. Results The COVID-19 pandemic has profoundly affected the mental health of many individuals, including children, adolescents, and their caregivers. Implementation of lockdowns, lifestyle disruptions, school closures, and social distancing have driven a surge in social media and digital technology use. The combination of predisposing factors, the psychological burden of the COVID-19 pandemic, and social media are implicated in the rise and spread of tic-like behaviors; which may represent a modern-day form of mass functional illness. While many of the features overlap with functional tics, there are emerging distinctive features that are important to recognize. A more encompassing term, Functional Tic-Like Behaviors , is used to better reflect multiple contributing factors. Conclusion Knowledge of these differences is essential to mitigate downstream health effects and poor outcomes.
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The case series sample is reflective of the sex composition of patients who presented to the clinical practices for treatment and is largely consistent with FTLB presentations in the population, with an estimated female:male ratio of 9:1.
“While this case series sample is reflective of the sex composition of the patients who presented to our clinical practices for treatment and is largely consistent with the FTLB presentations in the population, with an estimated female:male ratio of 9:1 (20, 29, 30)”
From Integrated cognitive behavioral intervention for functional tics (I-CBiT): case reports and treatment formulation (2023) · cites this paper as [30]
The Methods section on Functional Tic-Like Behaviors reports a female predominance in FTLB, with an exception in one German report. The 3:1 to 9:1 female predominance appears in the separate section on functional tics; the review does not establish a 9:1 ratio for FTLB presentations in the population. The statement about the citing authors’ own clinical sample is not a finding attributed to this review. (LLM, conf=0.86)
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The spectrum of functional tic-like behaviours: data from an international registry
Martino, D., Hedderly, T., Murphy, T., Müller‐Vahl, K. R., Dale, R. C., Gilbert, D. L., Rizzo, R., Hartmann, A., Nagy, P., Anheim, M., et al. (2023) · European Journal of Neurology · doi:10.1111/ene.15611 · Cited by 58 · see citing works
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“…academic pressures, political tensions, and social stressors [7]; presentations with functional somatic symptoms have increased around the globe [8–18]. context of climate change, cumulative natural disasters, the COVID-19 In our own clinical contexts—tertiary care hospitals in Sydney (Australia)…”
BackgroundVirtual schooling and pediatric mental health during the COVID-19 pandemic.
Leith, T. B., Forer, R., Rappaport, L., Malas, N., McCaffery, H., Sturza, J., Kullgren, K., Otto, A. K., & Monroe, K. (2024) · Clinical Pediatrics · doi:10.1177/00099228231209671 · Cited by 3 · see citing works
- Authors
- Martindale, J. M., & Mink, J. W.
- Affiliations
- Atrium Health Wake Forest Baptist (US)
- University of Rochester Medicine (US)
- Corresponding author
- Martindale, Jaclyn M.
- Venue
- Frontiers in Pediatrics
- Publisher
- Frontiers Media SA
- Published
- 2022-07-11
- Volume
- 10
- Pages
- 863919-863919
- ISSN
- 2296-2360 (ISSN-L)
- PMC
- PMC9309505
- OpenAlex
- W4285004656
- Cited by
- 34
- References
- 150
- Citations by year
- 2026: 9 · 2025: 4 · 2024: 8 · 2023: 9 · 2022: 4
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Pediatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- functional movement disorders, chronic tic disorders, COVID-19 pandemic, social media use, psychological burden, lockdown, school closures, social distancing, children and adolescents, mental health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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