Coprophenomena in Tourette syndrome.
The aims of this descriptive study were to examine the prevalence and associations of coprophenomena (involuntary expression of socially unacceptable words or gestures) in individuals with Tourette syndrome. Participant data were obtained from the Tourette Syndrome International Database Consortium. A specialized data collection form was completed for each of a subset of 597 consecutive new patients with Tourette syndrome from 15 sites in seven countries. Coprolalia occurred at some point in the lifetime of 19.3% of males and 14.6% of females, and copropraxia in 5.9% of males and 4.9% of females. Coprolalia was three times as frequent as copropraxia, with a mean onset of each at about 11 years, 5 years after the onset of tics. In 11% of those with coprolalia and 12% of those with copropraxia these coprophenomena were one of the initial symptoms of Tourette syndrome. The onsets of tics, coprophenomena, smelling of non-food objects, and spitting were strongly intercorrelated. Early onset of coprophenomena was not associated with its longer persistence. The most robust associations of coprophenomena were with the number of non-tic repetitive behaviors, spitting, and inappropriate sexual behavior. Although coprophenomena are a frequently feared possibility in the course of Tourette syndrome, their emergence occurs in only about one in five referred patients. Because the course and actual impact of coprophenomena are variable, additional prospective research is needed to provide better counseling and prognostic information.
Freeman
Roger D
RD
University of British Columbia, Vancouver, BC, Canada. rfreeman@cw.bc.ca
Zinner
Samuel H
SH
Müller-Vahl
Kirsten R
KR
Fast
Diane K
DK
Burd
Larry J
LJ
Kano
Yukiko
Y
Rothenberger
Aribert
A
Roessner
Veit
V
Kerbeshian
Jacob
J
Stern
Jeremy S
JS
Jankovic
Joseph
J
Loughin
Thomas
T
Janik
Piotr
P
Shady
Gary
G
Robertson
Mary M
MM
Lang
Anthony E
AE
Budman
Cathy
C
Magor
Alida
A
Bruun
Ruth
R
Berlin
Cheston M
CM
D001526:Behavioral Symptoms / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D012919:Social Behavior; D020323:Tics / Q000150:complications; D005879:Tourette Syndrome / Q000150:complications* / Q000523:psychology*; D014705:Verbal Behavior