Determinants of quality of life in children with Gilles de la Tourette syndrome

Abstract

The objective of this study is to assess the association between tic severity, attention deficit disorder, obsessive-compulsive behavior, and quality of life (QOL) in children with Gilles de la Tourette syndrome (GTS). GTS is a multidimensional disorder with disturbances in motor function and behavior. However, little is known about what variables are associated with QOL in these patients. We evaluated 56 outpatients with a diagnosis of GTS. The mean age was 10 (range 5-17 years). Tics were assessed with the Yale Global Tic Severity Scale (YGTSS). Behavioral scales included the Leyton Obsessional Inventory-Child Version, Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and Attention-Deficit/Hyperactivity Disorder (ADHD) rating scale. The patient's parent also completed the TNO-AZL Children's Quality of Life scale (TACQOL). YGTSS scores ranged from 4 to 30, indicating mild to moderate tic severity. Motor and phonic tic ratings were not correlated with QOL. However, both ADHD and OCD were significantly related to QOL. Subanalysis of ADHD subtypes demonstrated that inattentiveness but not hyperactivity predicted lower QOL. When ADHD, Leyton OCD, and tic severity were considered simultaneously, tic severity remained non-significant, while both ADHD and OCD remained significant contributors to QOL. In summary, in patients with mild to moderate GTS, QOL relates primarily to co-morbidities of ADHD and obsessive-compulsive behavior. ADHD with predominantly inattentive symptoms, rather than hyperactivity symptoms, was associated with lower QOL. To improve QOL, clinicians must consider treatments of co-morbidities among tic patients.

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