Tourette's syndrome in Monroe County school children

Abstract

We examined children from Monroe County, New York, to establish the prevalence of Gilles de la Tourette's syndrome (TS) in the county's schools. Patients were recruited for free evaluations from physicians, other health professionals, school personnel, and through extensive coverage in the local news media. Forty-one TS patients were detected among the 142,636 pupils enrolled in the county's public and private schools at the time of the study (estimated prevalence, 28.7 per 100,000). Twenty patients had obsessive-compulsive symptoms, but only three had an impairing, diagnosable disorder. Fifty-six percent had a positive family history for TS or tics. Eighteen needed pharmacotherapy, although, for most, TS was a mild disorder requiring no drug treatment.

Relationship between obsessive-compulsive disorders and diseases affecting primarily the basal ganglia

“…Gilles de la Tourette himself reported obsessive-compulsive behaviors in the cases he described in 1885. Several authors have described a frequency of obsessive-compulsive behavior in patients with TS greater than that found in the general population 9,10,11 .…”

“…In addition, Tourette's syndrome also appears to be related to the basal ganglia, and is often found in association with OCD 9,10,11 .…”

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

“…Prevalence figures range from 0.05% (Burd et al 1986a, b;Caine et al 1988) to 3% (Comings et al 1990, Mason et al 1998. The mode of inheritance may be autosomal dominant, but could also be accounted for by a mixed model (Walkup et al 1996, Barr and Sandor 1998, Rutter et al 1999.…”

Convulsive Tic Disorder Georges Gilles de la Tourette, Guinon and Grasset on the Phenomenology and Psychopathology of Gilles de la Tourette Syndrome

“…Antisocial behaviour, inappropriate sexual activity, exhibitionism, aggressive behaviour and discipline problems and self-injury are found in a substantial percentage of clinic GTS populations (Robertson, 1989;Robertson et ai., 1989). From our experience in clinical (Robertson et at., 1988;Robertson et at., 1989) and pedigree (Robertson and Gourdie, 1990) settings, and from the data of epidemiological surveys (Caine et at., 1988), it is suggested that relatively few GTS subjects in the community exhibit antisocial behaviours and that they are mild and not requiring treatment (Robertson, 1989).…”

“…In addition, coprolalia and echophenomena were significantly associated with obsessive-compulsive phenomena (Robertson et at., 1988). The argument for a strong association between GTS and OCD also comes from both pedigree (KurIan et at., 1986(KurIan et at., , 1987Pauls et at., 1986a, h;Comings and Comings, 1987;Robertson and Gourdie, 1990;Robertson and Trimble, 1990) and epidemiological (Caine et at., 1988) studies which suggest that not only do patients with mild GTS have significant obsessive-compulsive behaviours, but also that OCD may well be a phenotype of the anticipated GTS gene(s). It is therefore of added interest that in the GTS twin study of Jenkins and Ashby (1983), both twins were described as obsessional.…”