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Tourette syndrome in youth with and without obsessive compulsive disorder and attention deficit hyperactivity disorder

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Abstract

Chronic tic disorders (TD) are consistently found to have high rates of comorbidity with obsessive–compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD). The purpose of this study is to compare the severity of TD only to TD with comorbid OCD or ADHD based on severity of tics, measures of psychopathology and additional comorbid diagnoses. Baseline data from 158 youth with a chronic TD who participated in two longitudinal studies were examined. Fifty-three percent (N = 85) of the youth also met criteria for a diagnosis of OCD, 38.6 % (n = 61) met criteria for ADHD and 24.1 % (N = 38) met criteria for both. Measures of interest addressed severity of tics, symptoms of anxiety, depression, ADHD, psychosocial stress, global functioning and the presence of comorbid diagnoses. Youth with comorbid TD and OCD were characterized by more severe tics, increased levels of depressive and anxious symptoms, heightened psychosocial stress and poorer global functioning. Youth with comorbid TD and ADHD did not differ from those with TD alone on measures of tic severity, but experienced greater psychosocial stress and poorer global functioning. Subjects with comorbid TD and OCD had more internalizing disorders than those without OCD, while those with comorbid ADHD were more likely to meet criteria for oppositional defiant disorder. TD with OCD is a more severe subtype of TD than TD without OCD. TD with ADHD is associated with higher psychosocial stress and more externalizing behaviors. Further research is needed into the underlying relationships between these closely associated conditions.

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Acknowledgments

Eli R. Lebowitz gratefully acknowledges the support of the Messer Anxiety Program at the Yale Child Study Center.

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None.

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Authors and Affiliations

  1. Yale Child Study Center, 230 South Frontage Rd, New Haven, CT, 06520, USA

    Eli R. Lebowitz, Maria G. Motlagh, Liliya Katsovich, Robert A. King, Paul J. Lombroso, Heidi Grantz, Mary Jane Bentley & James F. Leckman

  2. Yale University, 230 South Frontage Rd, New Haven, CT, 06520, USA

    Haiqun Lin

  3. Division of Neurology at the Cincinnati Children’s Hospital Medical Center, University of Cincinnati Medical School, Cincinnati, OH, USA

    Donald L. Gilbert

  4. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Harvey S. Singer

  5. Child Study Center at the New York University School of Medicine, New York, NY, USA

    Barbara J. Coffey

  6. Atlantic Neuroscience Institute, Overlook Hospital, Summit, NJ, USA

    Roger M. Kurlan

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  1. Eli R. Lebowitz
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  2. Maria G. Motlagh
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  3. Liliya Katsovich
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  7. Haiqun Lin
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  8. Mary Jane Bentley
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  9. Donald L. Gilbert
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  10. Harvey S. Singer
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  11. Barbara J. Coffey
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  13. James F. Leckman
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the Tourette Syndrome Study Group

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Correspondence to Eli R. Lebowitz.

Additional information

E. R. Lebowitz and M. G. Motlagh contributed in equal measure to this study.

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Lebowitz, E.R., Motlagh, M.G., Katsovich, L. et al. Tourette syndrome in youth with and without obsessive compulsive disorder and attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry 21, 451–457 (2012). https://doi.org/10.1007/s00787-012-0278-5

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  • DOI: https://doi.org/10.1007/s00787-012-0278-5

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