[Comorbid disorders associated with tics].
BACKGROUND
Tics are the most frequent abnormal movements in children. This is one reason for their importance. Another reason is their relationship to fascinating disturbances of human behaviour such as compulsion and obsessions. Several 'behavioural disorders', mainly attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD), are more frequent in patients with tics than in the general population. These associated disorders (named 'comorbid') are probably of more consequence than the tics. Relationship between tics and comorbid disorders is not well known. This review considers data, consequences, hypothesis and management of comorbid disorders associated to tics.


METHODS
From the personal series of children with tics, data of comorbid disorders associated to tics was analysed. Of 340 cases of tics, 132 (39%) cases have ADHD, 135 (40%) cases have OCD, obsessive compulsive symptoms (OCS) or obsessive-compulsive behaviour (OCB). 68 (20%) cases have both ADHD and OCD. Considering only Tourette cases (219) the figures are only slight higher: ADHD (42%), OCD (45%) and ADHD plus OCD (24%) suggesting that all the spectrum of tics has a common basis.


CONCLUSIONS
Familial studies shows that 44 percent of the patients with tics have a positive familial history of tics and 30 percent positive familial history of obsessive compulsive signs. The data of the literature on the tics and comorbid disorders relationship is also revised.
Fernández-Alvarez
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Servicio de Neuropediatría, Hospital Sant Joan de Déu, Unidad Integrada de Pediatría, Universidad de Barcelona, Barcelona, Spain. efernand@medicina.ub.es
D001289:Attention Deficit Disorder with Hyperactivity; D002648:Child; D003072:Cognition Disorders / Q000503:physiopathology; D015897:Comorbidity; D003192:Compulsive Behavior / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder; D013981:Tic Disorders / Q000503:physiopathology* / Q000628:therapy; D005879:Tourette Syndrome