Tics and Tourette's disorder: a 2- to 7-year follow-up of 54 obsessive- compulsive children

Henrietta L. Leonard · Marge Lenane · Susan E. Swedo · David C. Rettew · Elliot S. Gershon · JUDITH L. RAPOPORT

316 citations0/0 files storedAmerican Journal of Psychiatry

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Obsessive-Compulsive Spectrum Disorders Psychoanalysis and Psychopathology Research Stuttering Research and Treatment

Abstract

OBJECTIVE: This study examined a hypothesized etiologic relationship between Tourette's disorder and obsessive-compulsive disorder. METHOD: Fifty-four children who had initially participated in treatment protocols for obsessive-compulsive disorder (Tourette's disorder was an exclusionary criterion) were reevaluated 2-7 years later with a neurological examination and a structured interview to establish the presence or absence of tics and Tourette's disorder. The children's first-degree relatives (N = 171) were also screened for tic disorders. RESULTS: At baseline, 57% (N = 31) of the patients had lifetime histories of tics. At follow-up, 59% (N = 32) had lifetime histories of tics; eight of these (all males) met the criteria for Tourette's disorder (six had developed the disorder, and two, it could be argued in retrospect, might have met the criteria at baseline). The patients with lifetime histories of tics had greater anxiety, a higher ratio of CSF 5-hydroxyindoleacetic acid to homovanillic acid, and a younger age at onset of obsessive-compulsive disorder than those without tics. The patients with Tourette's disorder differed from other male patients only in having an earlier age at onset of obsessive-compulsive disorder. Of the first-degree relatives, 1.8% (N = 3) had Tourette's disorder, and 14% (N = 24) had a tic disorder. CONCLUSIONS: Except for their earlier age at onset of obsessive-compulsive disorder, the patients with Tourette's disorder were indistinguishable from those without. The apparent high rate of tics and Tourette's disorder in the subjects and their relatives is consistent with the hypothesis that in some cases, obsessive-compulsive disorder and Tourette's disorder may be alternative manifestations of the same underlying illness.

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References

1983A Children's Global Assessment Scale (CGAS)1989Obsessive-Compulsive Disorder in Children and Adolescents 1989Cerebral Glucose Metabolism in Childhood-Onset Obsessive-Compulsive Disorder 1986Gilles de la Tourette's Syndrome and Obsessive-Compulsive Disorder 1985Clomipramine Treatment of Childhood Obsessive-Compulsive Disorder 1989High prevalence of obsessive-compulsive symptoms in patients with Sydenham's chorea 1989Obsessive-compulsive disorder in children and adolescents 1989Treatment of Obsessive-Compulsive Disorder With Clomipramine and Desipramine in Children and Adolescents

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1995Demographic and Clinical Features of Obsessive-Compulsive Disorder in Children and Adolescents 2004Obsessive-compulsive disorder phenotypes: implications for genetic studies 2005A family study of early-onset obsessive-compulsive disorder 1994Tic‐related vs. non‐tic‐related obsessive compulsive disorder 2002Genome‐wide linkage analysis of families with obsessive‐compulsive disorder ascertained through pediatric probands

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