title: Tourette's syndrome: what are the influences of gender and comorbid obsessive-compulsive disorder?
abstract: OBJECTIVE
  To explore the influence of gender and comorbid obsessive-compulsive disorder (OCD) on the phenomenology of Tourette's syndrome (TS).
  
  
  METHODS
  TS proband groups defined by gender and comorbid OCD status were compared on a variety of sociodemographic variables, clinical characteristics, and perinatal complications.
  
  
  RESULTS
  Compared to females, males more often onset with rage and had ever experienced any form of simple tics. Females onset with compulsive tics more often than males. Probands with comorbid OCD were more likely than those without OCD to onset with complex tics. Delivery complications, especially forceps deliveries, were associated with being male and with having OCD. Fetal exposure to relatively high levels of coffee, cigarettes, or alcohol predicted OCD in TS probands. Diagnosis of TS occurred at later ages among females than among males. Males and females displayed different age distributions.
  
  
  CONCLUSIONS
  Males and females tend to experience different kinds of symptoms at onset. However, the overall experience of TS appears to be similar for both groups. Perinatal brain injury is implicated in the etiology of TS in some boys. Early brain injury may cause or exacerbate the development of OCD in some TS sufferers.
authors.affiliation: Department of Epidemiology, Harvard Program in Psychiatric Epidemiology and Biostatistics, Harvard School of Public Health, Boston, MA.
authors.forename: S L
authors.initials: SL
authors.lastname: Santangelo
authors.forename: D L
authors.initials: DL
authors.lastname: Pauls
authors.forename: J M
authors.initials: JM
authors.lastname: Goldstein
authors.forename: S V
authors.initials: SV
authors.lastname: Faraone
authors.forename: M T
authors.initials: MT
authors.lastname: Tsuang
authors.forename: J F
authors.initials: JF
authors.lastname: Leckman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001930:Brain Injuries / Q000150:complications; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000209:etiology; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D013981:Tic Disorders; D005879:Tourette Syndrome / Q000150:complications* / Q000175:diagnosis / Q000209:etiology