An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries

Abstract

We have established a multisite, international database of 3500 individuals diagnosed with Tourette syndrome (TS). The male:female ratio is 4.3:1 for the total sample, with wide variation among sites; the male excess occurs at every site. Anger control problems, sleep difficulties, coprolalia, and self‐injurious behavior only reach impressive levels in individuals with comorbidity. Anger control problems are strongly correlated with comorbidity, regardless of site, region, or whether assessed by neurologists or psychiatrists. The mean age at onset of tics is 6.4 years. At all ages, about 12% of individuals with TS have no reported comorbidity. The most common reported comorbidity is attention‐deficit‐hyperactivity disorder. Males are more likely to have comorbid disorders than females. The earlier the age at onset, the greater the likelihood of a positive family history of tics. An understanding of the factors producing these and other variations might assist in better subtyping of TS. Because behavioral problems are associated with comorbidity, their presence should dictate a high index of suspicion of the latter, whose treatment may be at least as important as tic reduction. The established database can be used as the entry point for further research when large samples are studied and generalizability of results is important.

Exploring the Impact of Chronic Tic Disorders on Youth: Results from the Tourette Syndrome Impact Survey

“…Scores on all negative scales (i.e., adverse family impact) were significantly higher in the CTD-Plus group, suggesting greater impairment in family functioning for families with youth who have both CTD and a comorbid condition. Compared to previous research, scores on the negative impact scale in the overall sample were similar to those reported for young adults (ages [16][17][18][19][20][21][22][23][24][25][26] with cerebral palsy (mean = 21.3, SD = 12.1) and higher than those with Down Syndrome (mean = 16.5, SD = 8.0). Scores on the negative impact scale in the CTD-Plus group were similar to scores reported for intellectual disability (mean = 24.5, SD = 11.2) but lower than for autism (mean = 28.9, SD = 9.0) [42].…”

“…Additional limitations to existing research include poor generalizability due to small treatment-seeking samples, which may exclude youth with mild tics, those who experience financial or geographic barriers to diagnosis and treatment, and those who choose not to seek clinical care (e.g., parents do not want to draw attention to condition, do not recognize symptoms or misattribute them to other causes, are opposed to medication or medical intervention, or prioritize treating other conditions due to psychosocial and/or cultural factors). In addition, TS studies using large samples tend to combine adult and youth data [e.g., 23,26,27], making it difficult to disentangle functional impairment in youth alone. An enhanced understanding of the impact of TS on youth would improve existing treatment and assessment efforts and help prioritize future developments in these clinical areas.…”

RETRACTED ARTICLE: Association of Catechol-O-methyltransferase val/met polymorphism with cognitive function in Gilles de la Tourette syndrome patients

“…The occurrence of GTS was always accompanied with obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD) and learning disorder [3]. In addition, the tics of GTS can also cause several problems in cognitive functions, including dysfunction in fronto-striatal pathways, and impairment in attention, memory and information processing [3], which would affect the growth and learning of children and adolescents [4][5][6]. However, there was still no effective prevention and treatment for the poor cognitive functions of GTS patients.…”

Epidemiological Survey of Tourette Syndrome in Children and Adolescents in Wenzhou of P.R. China

“…Because diagnostic standards and epidemiological survey methods (such as respondent, method, age-range and area) varied among different countries, the reported epidemiological survey results differ greatly [1]. Till date, epidemiological survey material on TS in the population is scarce.…”