Adulthood Outcome of Tic and Obsessive-Compulsive Symptom Severity in Children With Tourette Syndrome

TLDR

Tourette syndrome is a childhood‑onset neuropsychiatric disorder characterized by motor and phonic tics, many children of whom experience a reduction or complete resolution of tic symptoms during adolescence. The study aimed to clarify the clinical course of tic and obsessive‑compulsive disorder symptoms in children with TS and to determine whether baseline childhood clinical measurements predict symptom severity in late adolescence and early adulthood. A prospective cohort of 46 children with TS, evaluated before age 14, was followed for an average of 7.6 years with expert‑rated tic and OCD severity assessments, and 85 % reported tic reduction during adolescence. Higher tic severity in childhood predicted greater tic severity at follow‑up, while higher childhood IQ predicted more severe OCD at follow‑up; the peak tic severity occurred at age 10.6, the peak OCD severity about two years later, and 41 % of participants experienced moderate or greater OCD, which tended to persist longer than tic symptoms.

Abstract

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).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.Prospective cohort study.Yale Child Study Center tic and OCD outpatient specialty clinic.Forty-six children with TS who received a structured clinical evaluation prior to age 14 years.Expert-rated tic and OCD symptom severity at follow-up interview an average of 7.6 years later (range, 3.8-12.8 years).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.Obsessive-compulsive disorder symptoms in children with TS became more severe at a later age and were more likely to persist than tic symptoms.