title: A preliminary examination of self-concept in older adolescents and young adults with Gilles de la Tourette syndrome.
abstract: BACKGROUND
  Gilles de la Tourette syndrome (GTS) is a childhood-onset neuropsychiatric disorder characterised by multiple tics and often associated with behavioural problems. Although there is evidence of significantly reduced self-esteem in children and adolescents with GTS, little is known about perceived self-concept and its clinical determinants at the transition age between adolescence and adulthood. We therefore set out to investigate self-concept in a clinical sample of young patients with GTS at this crucial age for personal development.
  
  
  METHODS
  In addition to standard demographic and clinical data, we collected self-ratings using a standardised battery of psychometric instruments, as well as the Multidimensional Self Concept Scale, a comprehensive questionnaire developed to assess self-concept in subjects aged 9- to 19 years, tapping into the social, competence, affect, academic, family, and physical domains.
  
  
  RESULTS
  We found that patients diagnosed with at least one co-morbid psychiatric disorder ("GTS-plus" phenotype) reported significantly lower self-concept than patients with "pure GTS", whereas tic-related variables had no impact on self-concept. Anxiety symptoms were the main determinants of self-concept, especially trait anxiety with regard to social and affective domains. Affective symptoms could also have a negative impact on the physical, affective, competence, and social domains of self-concept.
  
  
  CONCLUSIONS
  Routine screening for anxiety and affective symptoms should be recommended in all patients with GTS seen at transition clinics from paediatric to adult care, in order to implement effective treatment interventions whenever possible.
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University, Rome, Italy.
authors.forename: Paola R
authors.initials: PR
authors.lastname: Silvestri
authors.affiliation: Department of Cell Biology and Neuroscience, National Institute of Health, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Chiarotti
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Baglioni
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Neri
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cardona
authors.affiliation: Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, United Kingdom; Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, London, United Kingdom; School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, United Kingdom. Electronic address: a.cavanna@ion.ucl.ac.uk.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D011795:Surveys and Questionnaires; D005879:Tourette Syndrome / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult
keywords: Anxiety; Depression; Gilles de la Tourette syndrome; Psychiatric co-morbidities; Self-concept; Tics