Other Psychiatric Comorbidities in Tourette Syndrome

Abstract

AbstractSymptoms of anxiety and depression occur at elevated rates in patients with Tourette syndrome (TS) and their family members. In children and young adolescents, anxiety symptoms put persons at risk for later tic persistence. Obsessive–compulsive disorder (OCD) symptoms in childhood put persons at risk for later development of anxiety and depressive symptoms. In adults (specifically adult women), there is a relationship between tic severity and anxious and depressive symptoms. Specifically comorbid OCD in children and adolescents puts TS individuals at risk to develop (internalizing) anxiety and depressive symptoms, whereas comorbid attention-deficit/hyperactivity disorder (ADHD) mostly puts individuals at risk to develop disruptive and externalizing behaviors. Environmental adversities (negative family environment factors and psychosocial stressors) strongly contribute to comorbidity with anxiety and depression in TS. In adults with TS, personality disorders are prevalent. Dimensional personality ratings indicate that neuroticism seems to be mostly associated with tics. Dysfunctions of cognitive flexibility and planning are more often related to comorbid OCD and autism traits in TS, and inhibition problems are more often linked to comorbid ADHD in TS. Intellectual ability is normally distributed in TS. The prevalence of learning disabilities (LDs) in TS is similar to that in the general population. Comorbidities with ADHD and—to a lesser extent—with OCD seem to increase the prevalence of LDs. In addition to the fact that dyslexia is the most common learning disability in general, children with TS tend to have problems with mathematics and written language. Rage attacks are frequent in TS.