title: Long term clinical course of Tourette syndrome.
abstract: BACKGROUND
  Recent studies using cluster analysis and factor analysis have suggested that Tourette Syndrome (TS) should no longer be considered a unitary condition.
  
  
  METHODS
  We retrospectively studied the long term clinical course of 100 TS patients. The patients were assessed at the onset and after 10 years follow-up to evaluate the severity of tic, the Obsessive Compulsive Disorder (OCD), the Attention Deficit Hyperactivity Disorder (ADHD) and the presence of anxiety and depression, rage attacks, self injuries behavior. Moreover at the follow-up they completed an evaluation scale on quality of life to assess the impairment in everyday life after 10 years of illness.
  
  
  RESULTS
  The "pure TS" clinical group (38 subjects) showed after 10 years follow-up that 58% carried on with the same clinical phenotype, whereas 42% changed in "TS+OCD" phenotype. Fifty-five percentage required pharmacological treatment. All the "TS+ADHD" clinical group (48 subjects) showed after 10 years follow-up a different clinical phenotype: 62% "TS pure" phenotype, 35% "TS+OCD" phenotype, 2% "TS+ADHD+OCD" phenotype. Sixty-five percentage of the subject required pharmacological treatment. The "TS+ADHD+OCD" clinical group (14 subjects) after 10 years follow-up showed that 14% carried on with the same clinical phenotype, whereas 8.3% presented "TS pure" phenotype and 92% presented "TS+OCD" phenotype. Seventy-one percentage were in need of therapy. With regards to quality of life, patients presented widespread impairment correlated to the presence of comorbid conditions.
  
  
  CONCLUSIONS
  Our findings suggest that pure TS has quite a good long-term clinical course. By contrast, those who presented comorbid condition at the onset showed a more severe prognosis.
authors.affiliation: Section of Child Neuropsychiatry, Maternal-Infantile and Radiological Sciences Department, Catania University, Via Santa Sofia 78, 95123 Catania, Italy. rerizzo@unict.it
authors.forename: Renata
authors.initials: R
authors.lastname: Rizzo
authors.forename: Mariangela
authors.initials: M
authors.lastname: Gulisano
authors.forename: Paola Valeria
authors.initials: PV
authors.lastname: Calì
authors.forename: Paolo
authors.initials: P
authors.lastname: Curatolo
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000150:complications; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications; D010641:Phenotype; D011788:Quality of Life; D011889:Rage; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000150:complications; D012720:Severity of Illness Index; D013995:Time; D005879:Tourette Syndrome / Q000523:psychology*