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Michael H. Bloch, BA; Bradley S. Peterson, MD; Lawrence Scahill, MSN, PhD; Jessica Otka, BA; Lily Katsovich, MS; Heping Zhang, PhD; James F. Leckman, MD

Arch Pediatr Adolesc Med. 2006;160:65-69.

Background  Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder that is characterized by both motor and phonic tics. One half to two thirds of children with TS experience a reduction or complete resolution of tic symptoms during adolescence. At least one third of adults with TS have comorbid obsessive-compulsive disorder (OCD).

Objectives  To clarify the clinical course of tic and OCD symptoms in children with TS and determine if baseline clinical measurements in childhood are associated with future symptom severity in late adolescence and early adulthood.

Design  Prospective cohort study.

Setting  Yale Child Study Center tic and OCD outpatient specialty clinic.

Participants  Forty-six children with TS who received a structured clinical evaluation prior to age 14 years.

Main Outcome Measures  Expert-rated tic and OCD symptom severity at follow-up interview an average of 7.6 years later (range, 3.8-12.8 years).

Results  Eighty-five percent of subjects reported a reduction in tic symptoms during adolescence. Only increased tic severity in childhood was associated with increased tic severity at follow-up. The average age at worst-ever tic severity was 10.6 years. Forty-one percent of patients with TS reported at one time experiencing at least moderate OCD symptoms. Worst-ever OCD symptoms occurred approximately 2 years later than worst-ever tic symptoms. Increased childhood IQ was strongly associated with increased OCD severity at follow-up.

Conclusion  Obsessive-compulsive disorder symptoms in children with TS became more severe at a later age and were more likely to persist than tic symptoms.

Author Affiliations: Yale Child Study Center, the General Clinical Research Center, and the Departments of Pediatrics and Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn (Mr Bloch; Drs Scahill, Zhang, and Leckman; and Mss Otka and Katsovich); Division of Child and Adolescent Psychiatry and the Magnetic Resonance Imaging Unit, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York (Dr Peterson).

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