The behavioral spectrum of tic disorders: A community-based study

BackgroundTourette syndrome (TS) and related tic disorders are commonly associated with obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD). It has been argued, however, that any observed association between TS and these and other psychopathologies may be due to ascertainment bias in that individuals with multiple problems are more likely to be referred for medical evaluation. MethodsIn order to overcome the potential confounding by ascertainment bias, the authors conducted a community-based study of school children using direct interviews to determine the prevalence of tic disorders and any comorbid psychopathology. A standard psychiatric interview and standardized rating scales were utilized to diagnose childhood behavioral disorders. ResultsOf the 1,596 children interviewed, 339 were identified as having tics. The following psychopathologies were found more commonly (p < 0.05) in the children with tics: OCD, ADHD, separation anxiety, overanxious disorder, simple phobia, social phobia, agoraphobia, mania, major depression, and oppositional defiant behavior. ConclusionThe behavioral spectrum of tic disorders includes OCD, other anxiety disorders, a mood disorder, and attention-deficit and disruptive behavior disorders.

[1]  J. Kulisevsky,et al.  Bipolar Disorder in Adult Patients with Tourette’s Syndrome: A Clinical Study , 1998, Biological Psychiatry.

[2]  M. Mcdermott,et al.  Bilineal transmission in Tourette's syndrome families , 1994, Neurology.

[3]  M Ashtari,et al.  Reduced caudate nucleus volume in obsessive-compulsive disorder. , 1995, Archives of general psychiatry.

[4]  J. Kidd,et al.  Progress in the search for genetic linkage with Tourette syndrome: an exclusion map covering more than 50% of the autosomal genome. , 1991, American journal of human genetics.

[5]  J. Jankovic,et al.  Bilineal transmission in Tourette syndrome , 1999, Neurology.

[6]  J. Leckman,et al.  A family study of Gilles de la Tourette syndrome. , 1991, American journal of human genetics.

[7]  D. Cohen,et al.  Familial relationship between Gilles de la Tourette's syndrome, attention deficit disorder, learning disabilities, speech disorders, and stuttering. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[8]  D. Comings,et al.  A controlled study of Tourette syndrome. I. Attention-deficit disorder, learning disorders, and school problems. , 1987, American journal of human genetics.

[9]  J. Piacentini,et al.  Sensitivity of the Diagnostic Interview Schedule for Children, 2nd edition (DISC-2.1) for specific diagnoses of children and adolescents. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[10]  D. Comings,et al.  Tourette's syndrome and attention deficit disorder with hyperactivity: are they genetically related? , 1984, Journal of the American Academy of Child Psychiatry.

[11]  D. Benson,et al.  Obsessions and compulsions in Gilles de la Tourette's syndrome , 1986, Neurology.

[12]  R. Kurlan.  Tourette's syndrome , 1989, Neurology.

[13]  K. Kidd,et al.  Tourette syndrome and neuropsychiatric disorders: is there a genetic relationship? , 1988, American journal of human genetics.

[14]  J. Brown,et al.  Behavioral problems and severity of tics. , 1995, Journal of clinical psychology.

[15]  J. R. Baker,et al.  Functional magnetic resonance imaging of symptom provocation in obsessive-compulsive disorder. , 1996, Archives of general psychiatry.

[16]  M. Trimble,et al.  The Psychopathology of the Gilles de la Tourette Syndrome , 1988, British Journal of Psychiatry.

[17]  N. Alpert,et al.  Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labeled carbon dioxide and positron emission tomography. , 1994, Archives of general psychiatry.

[18]  M. Mcdermott,et al.  Prevalence of tics in schoolchildren and association with placement in special education , 2001, Neurology.

[19]  D. Pauls,et al.  Evidence for Autosomal Dominant Transmission in Tourette's Syndrome , 1993, British Journal of Psychiatry.

[20]  D. Comings,et al.  A controlled study of Tourette syndrome. III. Phobias and panic attacks. , 1987, American journal of human genetics.

[21]  J. Rapoport,et al.  The Leyton Obsessional Inventory--Child Version. , 1985, Psychopharmacology bulletin.

[22]  M. Robertson,et al.  Tourette syndrome, associated conditions and the complexities of treatment. , 2000, Brain : a journal of neurology.

[23]  D. Pauls.  Behavioural disorders: lessons in linkage , 1993, Nature Genetics.

[24]  R. Kurlan,et al.  Transient tic disorder and the spectrum of Tourette's syndrome. , 1988, Archives of neurology.

[25]  D. Lichter,et al.  Clinical evidence of genomic imprinting in Tourette's syndrome , 1995, Neurology.

[26]  M. Mesulam,et al.  Clinical comparison of Tourette's disorder and obsessive-compulsive disorder. , 1987, The American journal of psychiatry.

[27]  J. Mazziotta,et al.  Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. , 1992, Archives of general psychiatry.

[28]  M. Klug,et al.  Comorbid Tourette's disorder and bipolar disorder: an etiologic perspective. , 1995, The American journal of psychiatry.

[29]  R. Kurlan.  Difficulties in gene localization for Tourette's syndrome. Clinical aspects. , 1989, Molecular and chemical neuropathology.

[30]  D. Cohen,et al.  An epidemiologic study of Gilles de la Tourette's syndrome in Israel. , 1993, Archives of general psychiatry.

[31]  G. Gaffney,et al.  Somatic complaints in childhood tic disorders. , 1991, Psychosomatics.

[32]  K. Kidd,et al.  Segregation and linkage analyses of Tourette's syndrome and related disorders. , 1990, Journal of the American Academy of Child and Adolescent Psychiatry.

[33]  D. Comings,et al.  A controlled study of Tourette syndrome. VII. Summary: a common genetic disorder causing disinhibition of the limbic system. , 1987, American journal of human genetics.

[34]  D. Cohen,et al.  Evidence Against a Genetic Relationship between Tourette's Syndrome and Anxiety, Depression, Panic and Phobic Disorders , 1994, British Journal of Psychiatry.

[35]  J. Leckman,et al.  The inheritance of Gilles de la Tourette's syndrome and associated behaviors. Evidence for autosomal dominant transmission. , 1986, The New England journal of medicine.

[36]  H. Singer,et al.  Family study and segregation analysis of Tourette syndrome: evidence for a mixed model of inheritance. , 1996, American journal of human genetics.

[37]  D. Comings,et al.  A controlled study of Tourette syndrome. V. Depression and mania. , 1987, American journal of human genetics.

[38]  J. Rapoport,et al.  Neuroanatomical abnormalities in obsessive-compulsive disorder detected with quantitative X-ray computed tomography. , 1988, The American journal of psychiatry.

[39]  M. Trimble,et al.  Self-injurious behaviour and the Gilles de la Tourette syndrome: a clinical study and review of the literature , 1989, Psychological Medicine.

[40]  H. Singer,et al.  Development of behavioral and emotional problems in Tourette syndrome. , 1989, Pediatric neurology.

[41]  D. Comings,et al.  An epidemiologic study of Tourette's syndrome in a single school district. , 1990, The Journal of clinical psychiatry.