title: Clinical course of Tourette syndrome.
abstract: OBJECTIVE
  Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder characterized by multiple motor and vocal tics lasting at least a year in duration. Children with TS often experience comorbid conditions such as obsessive-compulsive disorder (OCD) and attention-deficit disorder. The goal of this article was to review the long-term clinical course of tics and comorbid conditions in children with TS.
  
  
  METHODS
  We conducted a traditional literature search to locate relevant articles regarding long-term outcome and prognosis in TS and tic disorders.
  
  
  RESULTS
  Tics typically have an onset between the ages of 4 and 6 years and reach their worst-ever severity between the ages of 10 and 12 years. On average, tic severity declines during adolescence. By early adulthood, roughly three-quarters of children with TS will have greatly diminished tic symptoms and over one-third will be tic free. Comorbid conditions, such as OCD and other anxiety and depressive disorders, are more common during the adolescence and early adulthood of individuals with TS than in the general population.
  
  
  CONCLUSIONS
  Although tics are the sine qua non of TS, they are often not the most enduring or impairing symptoms in children with TS. Measures used to enhance self-esteem, such as encouraging strong friendships and the exploration of interests, are crucial to ensuring positive adulthood outcome in TS.
authors.affiliation: Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA. michael.bloch@yale.edu
authors.forename: Michael H
authors.initials: MH
authors.lastname: Bloch
authors.forename: James F
authors.initials: JF
authors.lastname: Leckman
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D018450:Disease Progression; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000150:complications; D011379:Prognosis; D012720:Severity of Illness Index; D005879:Tourette Syndrome / Q000150:complications / Q000175:diagnosis*