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This study examined the psychometric properties of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS; Scahill et al., 1997). Participants were 82 children and adolescents diagnosed with obsessive-compulsive disorder (OCD). Confirmatory factor analyses of 2 previously found models (Obsessions and Compulsions; Disturbance and Severity) yielded poor fit indexes. Exploratory factor analysis supported a model of severity and disturbance with slightly different item content than found by McKay et al. (2003). The internal consistency of the factors was acceptable, and the convergent and divergent validity was supported vis-a-vis correlations with clinician ratings of impairment, self-report measures of depression and anxiety, and parent ratings of Tourette's disorder (TD) symptoms. These findings suggest that the CY-BOCS Total Score may represent an inaccurate assessment of symptom severity and supports the use of the revised Severity and Disturbance factors in assessing illness severity.

Characterized by multiple motor and phonic tics, Tourette syndrome (TS) is also associated with a constellation of comorbid disorders, including obsessive-compulsive symptoms that occur in 40-60 % of patients. The pathophysiology of tics has been linked by many studies to specific cortical and basal ganglia changes and hypothesized to relate to dysregulation of dopamine responsive/dependent circuits (Jordan et al., 2004). Aripiprazole, a recently released atypical antipsychotic noted for its partial D 2 agonist activity along with a low propensity for extrapyramidal effects, has been shown to be efficacious in reducing symptoms of schizophrenia in adults. The value of aripiprazole for treating neuropsychiatric disorders in children has not previously been reported. We present results of a retrospective chart review of six youth with TS and comorbid obsessivecompulsive disorder (OCD) who were treated for 12 wk with aripiprazole.All subjects were previously enrolled in an observational study at the University of Florida. Assessment instruments were given at 6-wk intervals to measure symptom severity in the areas of tics (YGTSS : Yale Global Tic Severity Scale; Leckman et al., 1989) and obsessions and compulsions (C-YBOCS : Children's Yale-Brown Obsessive Compulsive Scale ; Goodman et al., 1989). Subject information was also gathered on medication history, adverse effects and any illness diagnosed since their previous visit. While participating in this observational study, coincidentally, six subjects were placed on aripiprazole by their clinical physicians for treatment of tics. After receiving IRB approval, we did a retrospective chart review on these six subjects to determine if the aripiprazole had any effect on their symptom severity. There were four children and two adolescents (3 males, 3 females) ranging in age from 8 to 19 yr (average age 12.1¡4.05 yr). All of the subjects had TS with OCD. Four of the six subjects had received multiple previous medication trials with limited efficacy and were on one or more psychotropic medications.We reviewed charts from the observational study for scores on the assessment instruments listed above, along with weight, blood pressure, medication dose and adverse effects for the observational study visits coinciding with the pre-aripiprazole, and 12-wk post-aripiprazole time-period. The average prearipiprazole tic severity score on the YGTSS was 31.2 (8.3) with a range of 22-38 (instrument range 0-50) and pre-aripiprazole OCD severity score on the C-YBOCS was 28.2 (4.1) with a range of 22-34 (instrument range 0-40). The average dose of aripiprazole taken was 11.7 mg (range 5-20 mg) or 0.21 mg/kg (range 0.08-0.6 mg/kg). After 12 wk of treatment, the average tic severity score on the YGTSS was 13.7 (4.4) with a range of 8-18, a decrease of 56 %. The average OCD severity score on the C-YBOCS after 12 wk of treatment was 8.2 (5.5) with a range of 0-16, a decrease of 71 %. As noted in the charts, three subjects reported mild and transient adverse effects. One reported teeth chatt...

This study evaluated the psychometric properties of the Tourette's Disorder Scale-Parent Rated (TODS-PR), a 15-item parent-rated instrument that assesses a range of common symptoms seen in childhood Tourette's Disorder (TD) patients including tics, obsessions, compulsions, inattention, hyperactivity, aggression, and emotional disturbances. Participants were 67 children and adolescents ages 6-17 years who were diagnosed with TD and/or OCD and seen as a part of a larger study. Confirmatory factor analyses supported the original 4-factor structure of the TODS-PR with some slight re-specification of factor content. Internal consistencies were acceptable for the TODS-PR Total Score and factors. The TODS-PR Total Score and factors showed good convergent validity with other measures of symptomatology and impairment. These findings suggest that the TODS-PR is a reliable and valid parent-rating scale for assessing TD symptoms.