title: Predictors during childhood of future health-related quality of life in adults with Gilles de la Tourette syndrome.
abstract: BACKGROUND
  Gilles de la Tourette syndrome (GTS) is a chronic neurodevelopmental disorder characterised by multiple motor and phonic tics and behavioural problems. Patients with GTS of all ages often report a poor health-related quality of life (HR-QOL). The diagnosis of GTS is usually established in childhood but little is known about factors that predict the long-term well-being of patients, especially in the presence of co-morbid behavioural problems.
  
  
  OBJECTIVE
  To investigate the childhood predictors of HR-QOL in a cohort of adult patients with GTS.
  
  
  METHODS
  Forty-six patients with GTS aged 6-16 years underwent a baseline standardised clinical assessment of both tics and behavioural symptoms at a specialist GTS clinic. The same patients were re-assessed aged 16 years and above, with a mean follow-up period of 13 years (range 3-25 years), when they completed the Gilles de la Tourette Syndrome-Quality of Life Scale (GTS-QOL), a disease-specific measure of HR-QOL.
  
  
  RESULTS
  Tic severity, premonitory urges and family history of GTS were identified as predictors during childhood of a poorer HR-QOL in adults with GTS by multiple linear regression analysis. Specifically, tic severity significantly predicted poor outcome across physical, psychological and cognitive domains of the GTS-QOL, reflecting widespread effects on HR-QOL.
  
  
  CONCLUSIONS
  Young patients with severe tics associated with characteristic premonitory urges and a family history of tic disorders appear to be at higher risk for poorer HR-QOL as adults. Further prospective research into HR-QOL in GTS is required in order to inform long-term strategic resource allocation.
authors.affiliation: Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, United Kingdom. A.Cavanna@ion.ucl.ac.uk
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
authors.forename: Kate
authors.initials: K
authors.lastname: David
authors.forename: Michael
authors.initials: M
authors.lastname: Orth
authors.forename: Mary M
authors.initials: MM
authors.lastname: Robertson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003710:Demography; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000523:psychology; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D040841:Resource Allocation; D005879:Tourette Syndrome / Q000150:complications / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult