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An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries

Published online by Cambridge University Press:  01 July 2000

Roger D Freeman
Affiliation:
University of British Columbia, Vancouver, BC, Canada.
Diane K Fast
Affiliation:
University of British Columbia, Vancouver, BC, Canada.
Larry Burd
Affiliation:
University of North Dakota School of Medicine, Grand Forks, USA.
Jacob Kerbeshian
Affiliation:
University of North Dakota School of Medicine, Grand Forks, USA.
Mary M Robertson
Affiliation:
University College London Medical School, London, UK.
Paul Sandor
Affiliation:
University of Toronto, Canada.
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Abstract

We have established a multisite, international database of 3500 individuals diagnosed with Tourette syndrome (TS). The male:female ratio is 4.3:1 for the total sample, with wide variation among sites; the male excess occurs at every site. Anger control problems, sleep difficulties, coprolalia, and self-injurious behavior only reach impressive levels in individuals with comorbidity. Anger control problems are strongly correlated with comorbidity, regardless of site, region, or whether assessed by neurologists or psychiatrists. The mean age at onset of tics is 6.4 years. At all ages, about 12% of individuals with TS have no reported comorbidity. The most common reported comorbidity is attention-deficit–hyperactivity disorder. Males are more likely to have comorbid disorders than females. The earlier the age at onset, the greater the likelihood of a positive family history of tics. An understanding of the factors producing these and other variations might assist in better subtyping of TS. Because behavioral problems are associated with comorbidity, their presence should dictate a high index of suspicion of the latter, whose treatment may be at least as important as tic reduction. The established database can be used as the entry point for further research when large samples are studied and generalizability of results is important.

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Copyright
© 2000 Mac Keith Press

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