title: Depression in Tourette syndrome: A controlled and comparison study.
abstract: BACKGROUND
  Tourette syndrome (TS) is a neurodevelopmental condition characterised by multiple tics and co-morbid behavioural problems. Previous research found that up to 76% of patients with TS experience affective symptoms, with 13% fulfilling diagnostic criteria for depression.
  
  
  OBJECTIVE
  We aimed to assess the severity of depression and profile of depressive symptoms in adult patients with TS compared to patients with major depression and healthy controls.
  
  
  METHODS
  Depression ratings were collected from patients with TS (N=65) using the BDI-II and from patients with recurrent major depressive disorder (rMDD, N=696) and healthy controls (N=293) using the Beck Depression Inventory (BDI)-IA. Direct comparisons were possible for 14/21 BDI items.
  
  
  RESULTS
  Patients with TS scored significantly higher on the BDI than controls (P<0.001) and all individual symptoms were reported more frequently by patients with TS than by controls (P<0.001). Total BDI score in TS was not significantly different to that in rMDD, however irritability was significantly more frequently reported in the TS group and this remained significant after controlling for age and gender differences between the two groups (OR 5.24, 95% CI 1.97-14.00; P=0.001).
  
  
  CONCLUSIONS
  Our findings show that depression is a prominent feature in TS and may present with a more irritable phenotype than rMDD. Patients with TS should be routinely screened for depression to implement treatment as appropriate.
authors.affiliation: Michael Trimble Neuropsychiatry Research Group, University of Birmingham & BSMHFT, Birmingham, UK.
authors.forename: John Carlo P
authors.initials: JC
authors.lastname: Piedad
authors.affiliation: Michael Trimble Neuropsychiatry Research Group, University of Birmingham & BSMHFT, Birmingham, UK; School of Life and Health Sciences, Aston University, Birmingham, UK; Sobell Department of Motor Neuroscience and Movement Disorders, University College London & Institute of Neurology, London, UK. Electronic address: a.cavanna@ion.ucl.ac.uk.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D005879:Tourette Syndrome / Q000150:complications*; D006113:United Kingdom; D055815:Young Adult
keywords: Affective disorders; Depression; Irritability; Tics; Tourette syndrome