title: Health-related quality of life in patients with Gilles de la Tourette's syndrome.
abstract: To investigate the health-related quality of life (HrQoL) of adult patients with Gilles de la Tourette's syndrome (GTS) in Germany. HrQoL was evaluated in 200 adult patients with GTS (Mean age: 34.9 +/- 11.8 years). Patients were recruited from three outpatient departments in Germany and completed a semi-structured, self-rating interview. HrQoL was measured using the EQ-5D. Depression was assessed using the Beck's depression inventory (BDI) and clinical symptoms using the Yale Tourette syndrome symptom list (TSSL) and the Shapiro Tourette-syndrome severity scale (STSSS). Multivariate regression analyses were performed to identify independent predictors of HrQoL. Patients with GTS proved to have a worse HrQoL than a sample from the general German population. The domains most affected were anxiety/depression (57.1%), followed by pain/discomfort (47.5%), usual activities (38.4%), mobility (14%), and self-care (6.6%). The mean EQ-5D visual analog scale (EQ-VAS) was 65.4 +/- 21.9. The patients had a mean BDI score of 12.3 +/- 9.9, which was considerably worse compared to a healthy group who had a score of 6.45 +/- 5.2. The mean STSSS value was 3.2 +/- 1.1. In multivariate analyses, depressive symptoms contributed considerably, whereas the severity of symptoms as well as age only contributed minimally to HrQoL in the model (R(2) = 0.54). HrQoL is considerably reduced in adult patients with GTS. The main independent factors for determining HrQoL were depression, severity of symptoms, and age. Although, treatment of tics is important, co-morbidities such as depression should be diagnosed and treated vigorously.
authors.affiliation: Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Germany.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Müller-Vahl
authors.forename: Ines
authors.initials: I
authors.lastname: Dodel
authors.forename: Norbert
authors.initials: N
authors.lastname: Müller
authors.forename: Alexander
authors.initials: A
authors.lastname: Münchau
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Reese
authors.forename: Monika
authors.initials: M
authors.lastname: Balzer-Geldsetzer
authors.forename: Richard
authors.initials: R
authors.lastname: Dodel
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Oertel
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D005879:Tourette Syndrome / Q000503:physiopathology* / Q000523:psychology*