title: Prevalence and clinical correlates of explosive outbursts in Tourette syndrome.
abstract: The aim of this study was to examine the prevalence and clinical correlates of explosive outbursts in two large samples of individuals with Tourette syndrome (TS), including one collected primarily from non-clinical sources. Participants included 218 TS-affected individuals who were part of a genetic study (N=104 from Costa Rica (CR) and N=114 from the US). The relationships between explosive outbursts and comorbid attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), tic severity, and prenatal and perinatal complications were examined using regression analyses. Twenty percent of participants had explosive outbursts, with no significant differences in prevalence between the CR (non-clinical) and the US (primarily clinical) samples. In the overall sample, ADHD, greater tic severity, and lower age of tic onset were strongly associated with explosive outbursts. ADHD, prenatal exposure to tobacco, and male gender were significantly associated with explosive outbursts in the US sample. Lower age of onset and greater severity of tics were significantly associated with explosive outbursts in the CR sample. This study confirms previous studies that suggest that clinically significant explosive outbursts are common in TS and associated with ADHD and tic severity. An additional potential risk factor, prenatal exposure to tobacco, was also identified.
authors.affiliation: Department of Psychiatry, University of California San Francisco, CA 94143-0984, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Chen
authors.forename: Cathy L
authors.initials: CL
authors.lastname: Budman
authors.forename: Luis
authors.initials: L
authors.lastname: Diego Herrera
authors.forename: Joanna E
authors.initials: JE
authors.lastname: Witkin
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Weiss
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Lowe
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Freimer
authors.forename: Victor I
authors.initials: VI
authors.lastname: Reus
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mathews
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003364:Costa Rica / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011889:Rage; D012307:Risk Factors; D005879:Tourette Syndrome / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult