Date: 15 May 2007

Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome

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Abstract

Background

Tourette syndrome (TS) is a neurodevelopmental disorder with frequent comorbidity with Attention- deficit-Hyperactivity disorder (ADHD). The impact of this association is still a matter of debate.

Method

Using the TIC database containing 6,805 cases, the clinical differences were ascertained between subjects with and without ADHD.

Results

The reported prevalence of ADHD in TS was 55%, within the range of many other reports. If the proband was diagnosed with ADHD, a family history of ADHD was much more likely. ADHD was associated with earlier diagnosis of TS and a much higher rate of anger control problems, sleep problems, specific learning disability, OCD, Oppositional-defiant disorder, mood disorder, social skill deficits, sexually inappropriate behaviour, and self-injurious behaviour. Subjects with seizures and with Developmental Coordination Disorder also had high rates of ADHD. Anxiety disorder, however, was not more frequent. Preliminary data suggest that most behavioural difficulties in ADHD are associated with the Combined or Hyperactive-Impulsive Subtypes of ADHD. Every large site (>200 cases) had a significantly increased rate of anger control problems in cases with ADHD.

Conclusion

Subjects with TS have high rates of ADHD and complex associations with other disorders. Clinically the findings confirm other research indicating the importance of ADHD in understanding the behavioural problems often associated with the diagnosis of TS. Additional ADHD comorbidity should be taken into account in diagnosis, management, and training.

Active members of the Tourette Syndrome International Database Consortium (TIC) are: Henrik Aabech (Norway), Javad Allaghband-Rad (Iran), Cheston Berlin (USA), Ruth Bruun (USA), Cathy Budman (USA), Larry Burd (USA), Francesco Cardona (Italy), Francisco Cardoso (Brazil), Jose Castillo (Brazil), Susan Chien (Brazil), Sylvain Chouinard (Canada), Yves Dion (Canada), Jacques Eisenberg (Israel), Nihal Erfan (Saudi Arabia), Diane Fast (Canada), John Fayyed (Lebanon), Emilio Fernandez-Alvarez (Spain), Roger Freeman (Canada), Ken Gadow (USA), Oscar Gershanik (Argentina), Michel Gil (Canada), Don Gilbert (USA), Helga Hannesdottir (Iceland), Don Higgins (USA), Piotr Janik (Poland), Joseph Jankovic (USA), Bjorn Kadesjo (Sweden), Yukiko Kano (Japan), Jacob Kerbeshian (USA), Abraham Kessler (Israel), U Finn Knudsen (Denmark), Anne Korsgaard (Denmark), Anthony Lang (Canada), David Lichter (USA), Trygve Lindback (Norway), Zhisheng Liu (China), Danielle Lobel (Israel), Alida Magor (Israel), Euripides Miguel (Brazil), Kirsten Mueller-Vahl (Germany), Kieran O’Connor (Canada), Jessica Oesterheld (USA), Larry Pancer (Canada), Hugh Rickards (UK), Mary Robertson (UK), Veit Roessner (Germany), Aribert Rothenberger (Germany), Veit Roessner (Germany) Jeffrey Rubin (Canada), Evzen Ruzicka (Czech Republic), Kim St. John (Canada), Paul Sandor (Canada), Anton Scamvougeras (Canada), Gary Shady (Canada), Miriam Spinner (Canada), Mara Stamenkovic (Austria), Jeffrey Sverd (USA), Zsanett Tarnok (Hungary), Chris Van der Linden (Belgium), Arja Voutilainen (Finland), Yanki Yazgan (Turkey), Zheng Yi (China), Sam Zinner (USA)