Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome.
BACKGROUND
Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder that is characterized by both motor and phonic tics. One half to two thirds of children with TS experience a reduction or complete resolution of tic symptoms during adolescence. At least one third of adults with TS have comorbid obsessive-compulsive disorder (OCD).


OBJECTIVE
To clarify the clinical course of tic and OCD symptoms in children with TS and determine if baseline clinical measurements in childhood are associated with future symptom severity in late adolescence and early adulthood.


METHODS
Prospective cohort study.


METHODS
Yale Child Study Center tic and OCD outpatient specialty clinic.


METHODS
Forty-six children with TS who received a structured clinical evaluation prior to age 14 years.


METHODS
Expert-rated tic and OCD symptom severity at follow-up interview an average of 7.6 years later (range, 3.8-12.8 years).


RESULTS
Eighty-five percent of subjects reported a reduction in tic symptoms during adolescence. Only increased tic severity in childhood was associated with increased tic severity at follow-up. The average age at worst-ever tic severity was 10.6 years. Forty-one percent of patients with TS reported at one time experiencing at least moderate OCD symptoms. Worst-ever OCD symptoms occurred approximately 2 years later than worst-ever tic symptoms. Increased childhood IQ was strongly associated with increased OCD severity at follow-up.


CONCLUSIONS
Obsessive-compulsive disorder symptoms in children with TS became more severe at a later age and were more likely to persist than tic symptoms.
Bloch
Michael H
MH
Yale Child Study Center, and General Clinical Research Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.
Peterson
Bradley S
BS
Scahill
Lawrence
L
Otka
Jessica
J
Katsovich
Lily
L
Zhang
Heping
H
Leckman
James F
JF
D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy; D002648:Child; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000188:drug therapy; D011446:Prospective Studies; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D013981:Tic Disorders / Q000150:complications* / Q000188:drug therapy; D005879:Tourette Syndrome / Q000150:complications* / Q000188:drug therapy
D000316:Adrenergic alpha-Agonists; D014150:Antipsychotic Agents; D017367:Selective Serotonin Reuptake Inhibitors