Clinical phenomenology of episodic rage in children with Tourette syndrome.
OBJECTIVE
Episodic rage of unknown etiology causes significant morbidity in children with Tourette's syndrome (TS). Using modified Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for intermittent explosive disorder (IED), we developed a screen and symptom questionnaire to explore rage attack phenomenology and to preliminarily investigate whether symptom clusters can identify clinical subgroups of TS children with rage attacks.


METHODS
48 children with TS between ages 7 and 17 years consecutively presenting with rage attacks completed the Rage Attacks Screen and Questionnaire. Data was subjected to factor analysis. Cluster analytic procedures were used to identify clinical subgroups.


RESULTS
Final cluster solution revealed four homogeneous subgroups of TS children with rage who were differentiated by predominant clinical characteristics: specific urge resolution, environmentally secure reactivity, nonspecific urge resolution or labile nonresolving.


CONCLUSIONS
Episodic rage in TS has stereotypic features, but diverse and complex etiologies. Identifying particular symptom clusters may facilitate improved treatment strategies.
Budman
Cathy L
CL
New York University School of Medicine, New York City, USA.
Rockmore
Lori
L
Stokes
John
J
Sossin
Mark
M
D000293:Adolescent; D000374:Aggression; D002648:Child; D016000:Cluster Analysis; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011889:Rage; D011795:Surveys and Questionnaires; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000523:psychology