title: Children and adolescents with Tourette's disorder in the USA versus Argentina: behavioral differences may reflect cultural factors.
abstract: To explore behavioral differences as possible cultural factors in presentation of psychiatric comorbidity in two clinically referred, consecutively ascertained samples of youth with Tourette's disorder (TD) from New York and Buenos Aires. Subjects were evaluated between 2002 and 2010 at the Tics and Tourette's Clinical and Research Program at the New York University Child Study Center in New York and the Interdisciplinary Center for Tourette's, Obsessive Compulsive Disorder (OCD) and Associated Disorders (CITTTA)/Institute of Cognitive Psychology (INECO) in Buenos Aires. Demographic, diagnostic, tic severity (Yale Global Tic Severity Scale; YGTSS), clinical (Child Behavior Check List-Parent version; CBCL), and global functioning (Global Assessment of Functioning; GAF) data were compared using descriptive statistics. The sample included 111 subjects ages 6-17 years, who met DSM-IV-TR diagnostic criteria for TD. Findings revealed that the BA sample (n = 35) was significantly older at initial evaluation at the tic specialty clinic, and had higher frequency of oppositional defiant disorder (ODD), mood and non-OCD anxiety disorders than the NY sample (n = 76). There were no differences in gender distribution, age at tic onset or TD diagnosis, tic severity, proportion with current diagnoses of OCD/OC behavior or attention deficit hyperactivity disorder (ADHD), CBCL internalizing, externalizing, or total problems scores, YGTSS scores, or GAF scores. The observed similarities in demographic features, clinical presentation, rates of ADHD and OCD/OCB, and global impairment may reflect similar phenomenology and illness-related characteristics of TD in these referred youth. Differences in age at initial specialty clinic evaluation and rates of ODD, mood and non-OCD anxiety disorders may need further exploration before they may be considered to reflect cultural factors. Because of these limitations (e.g. small sample size), these results can be regarded only as preliminary.
authors.affiliation: Tics and Tourette's Clinical and Research Program, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Samar
authors.forename: María Beatriz
authors.initials: MB
authors.lastname: Moyano
authors.forename: Marta
authors.initials: M
authors.lastname: Braña-Berríos
authors.forename: Gustavo
authors.initials: G
authors.lastname: Irazoqui
authors.forename: Angeles
authors.initials: A
authors.lastname: Matos
authors.forename: Rafael
authors.initials: R
authors.lastname: Kichic
authors.forename: Resham
authors.initials: R
authors.lastname: Gellatly
authors.forename: Laura
authors.initials: L
authors.lastname: Ibanez-Gomez
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Zwilling
authors.forename: Eva
authors.initials: E
authors.lastname: Petkova
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Coffey
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D001118:Argentina / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000208:ethnology* / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000208:ethnology* / Q000523:psychology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013981:Tic Disorders / Q000175:diagnosis* / Q000453:epidemiology; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D014481:United States / Q000453:epidemiology