Article1999

The Tourette Syndrome Diagnostic Confidence Index

Mary May Robertson · Roger Kurlan · Donald J. Cohen · James Frederick Leckman · William McMahon · David L. Pauls +2 more

225 citations0/0 files storedNeurology

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Obsessive-Compulsive Spectrum Disorders Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Stuttering Research and Treatment

Abstract

BACKGROUND: The clinical characteristics of Tourette syndrome (TS) present challenges for the systematic determination of whether individuals are affected and severity. Vocal and motor tics wax and wane, decrease over time, and may be voluntarily suppressible, and therefore may be absent at interview. Current instruments measure symptoms at interview or rate symptom severity only. METHOD: To minimize error in case ascertainment and produce an instrument measuring lifetime likelihood of having had TS, clinical members of the American Tourette Syndrome Association International Genetic Collaboration developed the Diagnostic Confidence Index (DCI). The expert group worked collaboratively with progressive revision in consensus workshops using existing diagnostic criteria as guidelines. The DCI produces a score from 0 to 100 that is a measure of the likelihood of having or ever having had TS. RESULTS: The DCI was administered to 280 consecutive patients with TS attending a TS clinic; 264 (94%) completed it, indicating high feasibility and acceptability. Its correlation with other instruments and associations with psychopathology provide support for its being a lifetime measure of TS. CONCLUSIONS: The DCI is a useful, practicable instrument in the clinic or research practice allowing an assessment of lifetime likelihood of TS. Further work is needed to test the DCI's psychometric properties, such as its validity and reliability in populations of interest.

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References

1961An Inventory for Measuring Depression 1989The Yale Global Tic Severity Scale: Initial Testing of a Clinician-Rated Scale of Tic Severity 1981THE VALIDITY OF DEPRESSIVE DISORDER IN CHILDHOOD AND THE DEVELOPMENT OF A SELF‐RATING SCALE: A RESEARCH REPORT 1998Course of Tic Severity in Tourette Syndrome: The First Two Decades 1986Gilles de la Tourette's Syndrome and Obsessive-Compulsive Disorder 1989The Gilles de la Tourette Syndrome: the Current Status 1986The Leyton Obsessional Inventory-Child Version 1988The Psychopathology of the Gilles de la Tourette Syndrome

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2003Phenomenology of tics and natural history of tic disorders 2011Rare Copy Number Variants in Tourette Syndrome Disrupt Genes in Histaminergic Pathways and Overlap with Autism 2015A personal 35 year perspective on Gilles de la Tourette syndrome: prevalence, phenomenology, comorbidities, and coexistent psychopathologies 2017Neurobiology of the Premonitory Urge in Tourette’s Syndrome: Pathophysiology and Treatment Implications 2009Coprophenomena in Tourette syndrome

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