title: Self-, parent-, and teacher-reported behavioral symptoms in youngsters with Tourette syndrome: a case-control study.
abstract: OBJECTIVE
  Tourette syndrome (TS) is a neurodevelopmental disorder characterized by multiple tics and associated with co-morbid behavioral problems (TS-plus). We investigated the usefulness of self-report versus parent- and teacher-report instruments in assisting the specialist assessment of TS-plus in a child/adolescent population.
  
  
  METHODS
  Twenty-three patients diagnosed with TS (19 males; age 13.9 ± 3.7 years) and 69 matched healthy controls participated in this study. All recruited participants completed a standardized psychometric battery, including the Children's Depression Inventory (CDI), the Self Administrated Psychiatric Scales for Children and Adolescents (SAFA) and the State-Trait Anger Expression Inventory (STAXI). Parents completed the Child Behavior Checklist (CBCL) and Conners' Parent Rating Scales-Revised (CPRS-R). Participants' teachers completed the Conners' Teacher Rating Scales-Revised (CTRS-R). Results were compared with similar data obtained from controls.
  
  
  RESULTS
  Nineteen patients (82.6%) fulfilled DSM-IV-TR criteria for at least one co-morbid condition: obsessive-compulsive disorder (OCD, n = 8; 34.8%); attention deficit-hyperactivity disorder (ADHD, n = 6; 26.1%); OCD + ADHD (n = 5; 21.7%). Scores on self-report instruments failed to show any significant differences between TS and controls. Most subscores of the CPRS-R, CTRS-R, and CBCL were significantly higher for the TS group than controls. The TS + OCD subgroup scored significantly higher than the TS-OCD subgroup on the CBCL-Externalizing, Anxious/Depressed and Obsessive-Compulsive subscales.
  
  
  CONCLUSIONS
  Self-report instruments appear to have limited usefulness in assisting the assessment of the behavioral spectrum of young patients with TS. However, proxy-rated instruments differentiate TS populations from healthy subjects, and the CBCL can add relevant information to the clinical diagnosis of co-morbid OCD.
authors.affiliation: Child Neuropsychiatry Unit, Department of Experimental Medicine, University of Insubria, Varese, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Termine
authors.forename: Claudia
authors.initials: C
authors.lastname: Selvini
authors.forename: Umberto
authors.initials: U
authors.lastname: Balottin
authors.forename: Chiara
authors.initials: C
authors.lastname: Luoni
authors.forename: Clare M
authors.initials: CM
authors.lastname: Eddy
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D005178:Faculty; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D010290:Parents; D057566:Self Report / Q000592:standards; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult