title: Tourette syndrome and other tic disorders in childhood, adolescence and adulthood.
abstract: BACKGROUND
  Tourette syndrome is a combined motor and vocal tic disorder that begins in childhood and takes a chronic course. It arises in about 1% of all children, with highly varying severity. Transient and usually mild tics are seen in as many as 15% of all children in elementary school. The diagnosis is often delayed by several years.
  
  
  METHODS
  We selectively reviewed the pertinent literature, including the guidelines of the European Society for the Study of Tourette Syndrome for the diagnosis and treatment of tic disorders.
  
  
  RESULTS
  Tic disorders usually take a benign course, with spontaneous improvement in adolescence in about 90% of patients. Psychoeducation is the basis of treatment in each case and almost always brings marked emotional relief. Specific treatment is needed only for more severe tics and those that cause evident psychosocial impairment. 80-90% of patients with Tourette syndrome have comorbidities (attention deficit-hyperactivity disorder, obsessive-compulsive disorder, depression, anxiety, emotional dysregulation, autoaggression), which often impair their quality of life more than the tics do and therefore become the main target of treatment. There is little evidence for the efficacy of treatment for tics. Small-scale controlled studies with a brief follow-up period have been carried out for some neuroleptic drugs. Behavior therapy should be tried before drug treatment. A further option for very severely affected adults is deep brain stimulation.
  
  
  CONCLUSIONS
  Because of the low level of the available evidence, no definitive recommendations can be made for the treatment of tics.
authors.affiliation: Department of Child- and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Ulm, Germany. andrea.ludolph@uni-ulm.de
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Ludolph
authors.forename: Veit
authors.initials: V
authors.lastname: Roessner
authors.forename: Alexander
authors.initials: A
authors.lastname: Münchau
authors.forename: Kirsten
authors.initials: K
authors.lastname: Müller-Vahl
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D011613:Psychotherapy / Q000379:methods*; D020323:Tics / Q000175:diagnosis* / Q000628:therapy*; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000628:therapy*; D055815:Young Adult