Abstract
In daily clinical practice of child psychiatry tic disorders (TD) and attention-deficit/hyperactivity disorder (ADHD) as well as their co-existence are common and need careful evidence-based approaches in differential diagnostics and treatment choice. Hence, their relationship at different levels (e.g., psychopathology, neuropsychology, neurobiology, treatment) needs to be elucidated in more detail. The articles of this supplement deal with this subject. It is unclear if TD + ADHD represents an own clinical entity and which component (TD vs. ADHD) is most important in case of co-existence with respect to accompanying problems like emotional or cognitive disturbances. This editorial gives a short overview of the essential research topics concerning TD + ADHD and shows where (in this ECAP supplement and other literature) empirically based answers can be found. Probably, the identification of separate or common “endophenotypes” for TD-only, ADHD-only and for TD + ADHD would help to sort out the complexities and this supplement may nurture such a perspective of future research for a better understanding and treatment of youths with TD + ADHD and their families.
Similar content being viewed by others
References
Banaschewski T, Coghill D, Santosh P, Zuddas A, Asherson P, Buitelaar J, Danckaerts M, Döpfner M, Faraone SV, Rothenberger A, Sergeant J, Steinhausen HC, Sonuga-Barke EJ, Taylor E (2006) Long-acting medications for the hyperkinetic disorders: a systematic review and European guideline. Eur Child Adolesc Psychiatry 15:476–498
Banaschewski T, Neale BM, Rothenberger A, Roessner V (2007) Comorbidity of tic disorders and ADHD – conceptual and methodological considerations. Eur Child Adolesc Psychiatry 16(Suppl 1):I/5–I/14
Bloch MH, Peterson BS, Scahill L, Otka J, Katsovich L, Zhang H, Leckman JF (2006) Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome. Arch Pediatr Adolesc Med 160(1):65–69
Burd L, Freeman RD, Klug MG, Kerbeshian J (2005) Tourette syndrome and learning disabilities. BMC Pediatr 5:34–40
Burd L, Freeman RD, Klug MG, Kerbeshian J (2006) Variables associated with increased tic severity in 5,500 patients with Tourette Syndrome. J Dev Phys Disabil 18:13–24
Carter AS, O’Donnell DA, Schultz RT, Scahill L, Leckman JF, Pauls DL (2000) Social and emotional adjustment in children affected with Gilles de la Tourette’ syndrome: associations with ADHD and family functioning. J Child Psychol Psychiatry 41:215–223
Castellanos FX, Tannock R (2002) Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes. Nat Rev Neurosci 3:617–628
Denckla MB (2006) Attention deficit hyperactivity disorder. The childhood comorbidity that most influences the disability burden in Tourette Syndrome. In: Walkup JT, Mink JW, Hollenbeck PT (eds) Advances in neurology, vol 99, Tourette Syndrome. Williams and Wilkins, New York, Lippincott, pp 17–21
Doepfner M, Rothenberger A (2007) Behavior therapy in tic disorders with co-existing ADHD. Eur Child Adolesc Psychiatry 16(Suppl 1):I/89–I/99
Döpfner M, Roessner V, Rothenberger A (2007) Tic-Störungen. Göttingen, Hogrefe. (in press)
Erenberg G (2005) The relationship between Tourette syndrome, attention deficit hyperactivity disorder, and stimulant medication: a critical review. Semin Pediatr Neurol 12:217–221
Freeman R and the Tourette Syndrome International Database Consortium (2007) Tic disorders and ADHD – answers from a world-wide clinical data set on Tourette Syndrome. Eur Child Adolesc Psychiatry 16(Suppl 1):I/15–I/23
Gillberg C, Gillberg JC, Rasmussen P, Kadesjö B, Södertröm H, Råstam M, Johnson M, Rothenberger A, Niklasson L (2004) Co-existing disorders in ADHD – implications for diagnosis and intervention. Eur Child Adolesc Psychiatry 13(Suppl 1):80–92
Hoekstra PJ, Anderson GM, Troost PW, Kallenberg CGM, Minderaa RB (2007) Plasma kynurenine and related measures in tic disorder patients. Eur Child Adolesc Psychiatry 16(Suppl 1):I/71–I/77
Kadesjö B, Gillberg C (2001) The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychol Psychiatry 42:487–492
Khalifa N, von Knorring AL (2006) Psychopathology in a Swedish population of school children with tic disorders. J Am Acad Child Adolesc Psychiatry 45:1346–1353
Kirov R, Banaschewski T, Uebel H, Kinkelbur J, Rothenberger A (2007b) REM-sleep alterations in children with tic disorder and ADHD comorbidity – impact of hypermotor symptoms. Eur Child Adolesc Psychiatry 16(Suppl 1):I/45–I/50
Kirov R, Kinkelbur J, Banaschewski T, Rothenberger A (2007a) Sleep patterns in children with attention-deficit/hyperactivity disorder, tic disorder and comorbidity. J Child Psychol Psychiatry 48:561–570
Leckman JF, Vaccarino FM, Kalanithi PS, Rothenberger A (2006) Annotation: Tourette syndrome: a relentless drumbeat – driven by misguided brain oscillations. J Child Psychol Psychiatry 47:537–550
Marsh R, Alexander GM, Packard MG, Zhu H, Wingard JC, Quackenbush G, Peterson BS (2004) Habit learning in Tourette syndrome: a translational neuroscience approach to a developmental psychopathology. Arch Gen Psychiatry 61(12):1259–1268
Moll GH, Heinrich H, Trott GE, Wirth S, Bock N, Rothenberger A (2001) Children with comorbid attention-deficit hyperactivity disorder and tic disorder: evidence for additive inhibitory deficits within the motor system. Ann Neurol 49:393–396
MTA-Cooperation-Group (1999a) A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal treatment study of children with ADHD. Arch Gen Psychiatry 56:1073–1086
MTA-Cooperation-Group (1999b) Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 56:1088–1096
Plessen KJ, Royal JM, Peterson BS (2007) Neuroimaging of tic disorders with coexisting attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry 16(Suppl 1):I/60–I/70
Poncin Y, Sukhodolsky D, McGuire J, Scahill L (2007) The drug and non-drug treatment of children with ADHD and tic disorders. Eur Child Adolesc Psychiatry 16(Suppl 1):I/78–I/88
Robertson MM (2006) Attention deficit hyperactivity disorder, tics and Tourette’s syndrome: the relationship and treatment implications. A commentary. Eur Child Adolesc Psychiatry 15:1–11
Roessner V, Becker A, Banaschewski T, Rothenberger A (2006) Psychopathological profile in children with chronic tic disorder and co-existing ADHD: additive effects. J Abnorm Child Psychol 35:79–85
Roessner V, Becker A, Banaschewksi T, Rothenberger A (2007b) Executive functions in children with chronic tic disorders with/without ADHD – new insights. Eur Child Adolesc Psychiatry 16(Suppl 1):I/36–I/44
Roessner V, Becker A, Freeman R, Rothenberger A and the Tourette Syndrome International Database Consortium (2007a) Developmental psychopathology of children and adolescents with Tourette syndrome - impact of ADHD. Eur Child Adolesc Psychiatry 16(Suppl 1):I/24–I/35
Rothenberger A, Banaschewski T (2006) Tic-Disorders. In: Gillberg C, Harrington R, Steinhausen HC (eds) A Clinican’s handbook of child and adolescent psychiatry. Cambridge University Press, pp 598–624
Rothenberger A, Banaschewski T, Heinrich H, Moll GH, Schmidt MH, van’t Klooster B (2000) Comorbidity in ADHD children: coexisting conduct disorder but not tic disorder accompanied by brain electrical deficit in an auditiory selective attention task. Eur Arch Psychiat Clin Neurosci 250:101–110
Rothenberger A, Banaschewski T, Roessner V (2007) Tic-Störungen (Tic disorders). In: Herpertz-Dahlmann B, Resch F, Schulte-Markwort M, Warnke A (eds) Entwicklungspsychiatrie (Developmental psychiatry) (in press)
Scahill L, Sukhodolsky DG, Williams SK, Leckman JF (2005) Public health significance of tic disorders in children and adolescents. Adv Neurol 96:240–248
Scahill L, Williams S, Schwab-Stone M, Applegate J, Leckman JF (2006) Disruptive behavior problems in a community sample of children with tic disorders. In: Walkup JT, Mink JW, Hollenbeck PT (eds) Advances in neurology, vol 99, Tourette Syndrome. Williams and Wilkins, New York, Lippincott, pp 184–190
Spencer T, Biederman J, Harding M, O’Donnell D, Wilens T, Faraone S, Coffey B, Geller D (1998) Disentangling the overlap between Tourette’s disorder and ADHD. J Child Psychol Psychiatry 7:1037–1044
Steinhausen HC, Novik TS, Baldursson G, Curatolo P, Lorenzo MJ, Rodrigues Pereira R, Ralston SJ, Rothenberger A ADORE Study Group (2006) Co-existing psychiatric problems in ADHD in the ADORE cohort. Eur Child Adolesc Psychiatry 15(Suppl 1):i25–i29
Stewart SE, Illmann C, Geller DA, Leckman JF, King R, Pauls DL (2006) A controlled family study of attention-deficit/hyperactivity disorder and Tourette’s disorder. J Am Acad Child Adolesc Psychiatry 45:1354–1362
Sukhodolsky D, Leckman JF, Rothenberger A, Scahill L (2007) The role of abnormal neural oscillations in the pathophysiology of co-occurring Tourette syndrome and ADHD. Eur Child Adolesc Psychiatry 16(Suppl 1):I/51–I/59
Sukhodolsky DG, Scahill L, Zhang H, Peterson BS, King RA, Lombroso PJ, Katsovich L, Findley D, Leckman JF (2003) Disruptive behavior in children with Tourette’s syndrome: association with ADHD comorbidity, tic severity, and functional impairment. J Am Acad Child Adolesc Psychiatry 42:98–105
Taylor E, Döpfner M, Sergeant J, Asherson P, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Rothenberger A, Sonuga-Barke E, Steinhausen HC, Zuddas A (2004) European clinical guidelines for hyperkinetic disorder – first upgrade. Eur Child Adolesc Psychiatry 13(Suppl 1):7–30
Yordanova J, Heinrich H, Kolev V, Rothenberger A (2006) Increased event-related theta activity as a psychophysiological marker of comorbidity in children with tics and attention-deficit/hyperactivity disorders. NeuroImage 32:940–955
Zhu Y, Leung KM, Liu P, Zhou M, Su L (2006) Comorbid behavioural problems in Tourette’s syndrome are positive correlated with the severity of symptoms. Aust N Z J Psychiatry 40:67–73
Author information
Authors and Affiliations
Corresponding author
Additional information
Disclosure: The print of this supplement was financially supported by Janssen-Cilag, Germany.
Rights and permissions
About this article
Cite this article
Rothenberger, A., Roessner, V., Banaschewski, T. et al. Co-existence of tic disorders and attention-deficit/hyperactivity disorder-recent advances in understanding and treatment. Eur Child Adolesc Psychiatry 16 (Suppl 1), 1–4 (2007). https://doi.org/10.1007/s00787-007-1001-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-007-1001-9