Psychiatric disorders and behavioral problems in children and adolescents with Tourette syndrome.
OBJECTIVE
Many previous studies have surveyed associations between Tourette syndrome (TS) and co-morbid psychiatric disorders, but they usually did not include oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety disorder (SAD), and post-traumatic stress disorder (PTSD).


METHODS
The subjects were children and adolescents with TS who visited a child and adolescent psychiatric clinic, and who were interviewed using DSM-IV diagnostic criteria. Characteristics of their tics were examined by the Yale-Global Tic Severity Scale (Y-GTSS). Behavioral problems were surveyed by the Child Behavior Checklist (CBCL) filled in by the parents.


RESULTS
About 87.9% of the subjects were boys. The mean age of the subjects was 11.8 years. The most common psychiatric disorders were attention deficit hyperactivity disorder (ADHD), ODD, nail biting, and obsessive compulsive disorder (OCD). Only one subject was affected by TS without co-morbidities. Among TS patients with co-morbidities, those with disruptive behavioral disorders (DBD) have significantly higher mean scores than patients without DBD on the Externalizing scale, Social problems, Attention problems, Delinquent and Aggression scales. Co-morbidity of anxiety disorders was not related to the CBCL scores.


CONCLUSIONS
Many of our results were similar to those reported in studies conducted in other parts of the world. TS is more common in boys and nearly all of them had at least one co-morbid disorder. The most common co-morbidity was ADHD. Behavioral problems in TS are related to the co-morbidity with the DBD, and possibly not to the anxiety disorders.
Shiraz University of Medical Sciences, Hafez Hospital, Shiraz, Iran. ghanizad@sina.tums.ac.ir
Ahmad
A
Ghanizadeh
Sharif
S
Mosallaei
D000293:Adolescent; D000367:Age Factors; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology; D010552:Personality Assessment / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000592:standards / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D020323:Tics / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005879:Tourette Syndrome / Q000175:diagnosis / Q000453:epidemiology*