title: The Differential Impact of Tourette's Syndrome and Comorbid Diagnosis on the Quality of Life and Functioning of Diagnosed Children and Adolescents.
abstract: OBJECTIVE
  Tourette's syndrome (TS) is a neuropsychiatric disorder associated with adverse outcomes. High rates of comorbidity (80-90%) complicate presentation, yet the relationship among TS, common comorbid diagnoses, and adversity is not well understood. This research investigated the impact of comorbidity, and the discrete effects of common comorbid diagnoses, on quality of life (QoL) and functioning of youth with TS.
  
  
  METHODS
  A community sample of parents of youth with TS (n = 86) participated in this survey-based study. Differences in QoL (Pediatric Quality of Life Inventory) and rates of psychological, behavioral, and social difficulties (Strength and Difficulties Questionnaire) reported for youth with or without comorbid disorder were determined, in addition to outcomes associated with individual disorders.
  
  
  RESULTS
  Parametric and nonparametric analyses revealed strong associations between comorbidity and decreased global QoL, impaired emotional and school functioning, and increased emotional symptomatology (p < .001). The impact of individual comorbid disorders was restricted and disorder specific, and TS was uniquely associated with impaired social functioning and peer relationship problems.
  
  
  CONCLUSIONS
  Understanding the risks associated with TS, particularly to psychosocial well-being, and the specific risks accompanying individual comorbid disorders, may improve assessment, prioritization of treatment goals, and interventions targeting the individual, multidimensional needs of youth with TS.
authors.affiliation: James Cook University, Townsville, Queensland, Australia; Edward Helmes, PhD, is Professor, Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: Deirdre
authors.initials: D
authors.lastname: O'Hare
authors.affiliation: James Cook University, Townsville, Queensland, Australia; Edward Helmes, PhD, is Professor, Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: Edward
authors.initials: E
authors.lastname: Helmes
authors.affiliation: School of Psychological Sciences, Australian College of Applied Psychology, Melbourne, Victoria, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Reece
authors.affiliation: School of Psychiatry, University of New South Wales, Kensington, Sydney, New South Wales, Australia.
authors.forename: Valsamma
authors.initials: V
authors.lastname: Eapen
authors.affiliation: Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: Kerry
authors.initials: K
authors.lastname: McBain
mesh_terms: D000293:Adolescent; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D005879:Tourette Syndrome / Q000453:epidemiology / Q000523:psychology*
keywords: Comorbid; Tourette; functioning; psychosocial; quality of life