title: Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach.
abstract: OBJECTIVE
  Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities.
  
  
  METHODS
  The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates.
  
  
  RESULTS
  In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Rodgers
authors.forename: M
authors.initials: M
authors.lastname: Müller
authors.forename: W
authors.initials: W
authors.lastname: Kawohl
authors.forename: D
authors.initials: D
authors.lastname: Knöpfli
authors.forename: W
authors.initials: W
authors.lastname: Rössler
authors.forename: E
authors.initials: E
authors.lastname: Castelao
authors.forename: M
authors.initials: M
authors.lastname: Preisig
authors.forename: V
authors.initials: V
authors.lastname: Ajdacic-Gross
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology; D010641:Phenotype; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012727:Sex Characteristics; D013557:Switzerland / Q000453:epidemiology; D013981:Tic Disorders / Q000145:classification* / Q000453:epidemiology* / Q000523:psychology
keywords: Gilles de la Tourette syndrome; epidemiology; latent class analysis; tic disorders