title: Tourette syndrome and chronic tic disorder are associated with lower socio-economic status: findings from the Avon Longitudinal Study of Parents and Children cohort.
abstract: OBJECTIVE
  Only a few studies have examined the relationship between Tourette syndrome or chronic tic disorder and socio-economic status (SES). Existing studies are primarily cross-sectional, arise from specialty clinics, and use single measures of SES. In this study we examine this relationship in a longitudinal, population-based sample.
  
  
  METHODS
  Data are from 7152 children born during 1991 and 1992 in the county of Avon, UK, from the Avon Longitudinal Study of Parents and Children, who were followed up to age 13. After exclusions for intellectual disability* and autism, 6768 participants (3351 males [49.5%]) and 3417 females [50.5%]) remained. Parental SES was assessed using multiple measures during pregnancy and at 33 months of age. Presence of Tourette syndrome or chronic tics was determined from repeated maternal questionnaires up to when the child was 13 years of age.
  
  
  RESULTS
  Multiple SES measures were associated with an approximately twofold increased risk of Tourette syndrome and chronic tics. A postnatal composite factor score (lowest vs highest tertile odds ratio 2.09, 95% confidence interval 1.38-3.47) provided the best fit to the data.
  
  
  CONCLUSIONS
  As is seen in several childhood conditions, such as cerebral palsy and autism, lower SES is a risk factor for Tourette syndrome/chronic tics. Potential explanations include differential exposure to environmental risk factors or parental psychopathology as a measure of an increased genetic risk leading to decreased parental SES.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Miller
authors.forename: Jeremiah M
authors.initials: JM
authors.lastname: Scharf
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mathews
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006798:Housing; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009460:Neurologic Examination; D016017:Odds Ratio; D011610:Psychosocial Deprivation; D012307:Risk Factors; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D005879:Tourette Syndrome / Q000453:epidemiology*; D006113:United Kingdom