TOURETTE'S SYNDROME - COMORBIDITY

COMORBID OR ASSOCIATED CONDITIONS

A significant percentage of children and teens with Tourette's Syndrome who are seen in clinical settings also have symptoms of other disorders or conditions. It is important, however, to keep this caveat in mind: we really don't know what percentage of all people with TS will have other problems or disorders because what we see in clinical settings may represent only the more severe end of the spectrum and not the majority of children or teenagers with TS.

So, what other disorders tend to be associated with or frequently comorbid with TS? The answer depends on whom you ask and whether the research is based on a clinical sample or a community-based sample. That said, the majority of clinical settings report that a significant percentage of individuals who have TS also have:

• Obsessive-compulsive behaviors or Obsessive-Compulsive Disorder (OCD)
• Attention Deficit Hyperactivity Disorder
• Mood disorders such as depression and Bipolar Disorder
• Non-OCD anxiety disorders

Some researchers, including David Comings, MD, have suggested that there are many other disorders that are also linked to TS.

In a community-based study of school children that employed direct interviews and standardized rating scales for 1596 children, Kurlan and his colleagues (2002) found that OCD, ADHD, separation anxiety, overanxious disorder, simple phobia, social phobia, agoraphobia, mania, major depression, and oppositional defiant behavior occurred significantly more frequently in the children who had tics compared to their non-tic peers. But are all of these conditions really associated with tics, or is it the case that some of them are just associated with each other? For example, could it be that you don't find oppositional defiant behavior unless there is also ADHD? There is much that we don't know about what is truly associated with TS and what conditions are only present if there is ADHD or OCD in the presence of TS. Additional research is clearly needed to help identify patterns.