Rage attacks in children and adolescents with Tourette's disorder: a pilot study.
BACKGROUND
Sudden, explosive episodes of rage occur in a significant number of clinically referred children with Tourette's disorder and cause considerable psychosocial morbidity. The etiology of these symptoms is unknown. We conducted a pilot study of 12 consecutive children with Tourette's disorder and rage attacks to determine whether comorbidity of Tourette's-associated disorders is related to these symptoms.


METHODS
Twelve consecutive children with Tourette's disorder who presented with rage attacks were evaluated, including 2 females and 10 males. Tourette's disorder diagnosis, presence of comorbid disorders, and tic severity were assessed using DSM-IV diagnostic criteria and standardized rating scales.


RESULTS
All 12 children met diagnostic criteria for Tourette's disorder, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD). Two children were also diagnosed with comorbid oppositional defiant disorder, and 4 children were diagnosed with comorbid conduct disorder. None of the subjects met diagnostic criteria for a mood disorder. All subjects had only mild tic severity.


CONCLUSIONS
The clinical phenomenon of rage attacks in children with Tourette's disorder resembles intermittent explosive disorder and may reflect specific underlying neurologic disturbances. This pilot study suggests that rage attacks in Tourette's disorder may be related to the presence of comorbid disorders.
Budman
C L
CL
Department of Psychiatry, New York University School of Medicine, North Shore University Hospital, Manhasset 11030, USA.
Bruun
R D
RD
Park
K S
KS
Olson
M E
ME
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D009518:New York / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011889:Rage; D012720:Severity of Illness Index; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology