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Tourette Syndrome and social functioning in a Canadian population

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Two hundred and ten patients with Tourette Syndrome (TS) and/or their parents completed a survey, answering questions about the frequency and disruptiveness of vocal and motor tics, behaviour problems and sleep disturbances. Respondents also rated the impact of TS symptoms on social relationships and level of personal and social functioning. Motor tics were reported to be more problematic than were vocal tics. Disruptive behavioural problems included obsessive-compulsive rituals, hyperactivity, anxiety, temper tantrums, mood swings, aggressiveness and coprolalia. Respondents also reported problems getting to sleep, bad dreams, somnambulism and enuresis. More than 40% of respondents reported problems in dating, and problems in making and keeping friends. Family members, friends and physicians were reported to be the most understanding and tolerant of TS symptoms; employers were rated as being the least understanding. More than 30% of respondents reported some problems in coping, but more than 50% of respondents also rated their mental health as good or excellent.

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    The earliest reports of patients with Gilles de la Tourette syndrome and the subsequent empirical studies led to the assumption that tics cease during sleep (reviewed by Rothenberger et al., 2001). However, in recent years, evidence from different sources has indicated that tics can appear during sleep in some patients (Champion et al., 1988). Polysomnographic studies have shown that although tics may occur during sleep, they are substantially reduced in both frequency and amplitude (Jankovic and Rohaidy, 1987; Silvestri et al., 1990, 1995; Fish et al., 1991).

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