Prevalence of Tourette syndrome and chronic tics in the population-based Avon longitudinal study of parents and children cohort.
- Authors
- Scharf, Jeremiah M; Miller, Laura L; Mathews, Carol A; Ben-Shlomo, Yoav
- Year
- 2012
- Journal
- Journal of the American Academy of Child and Adolescent Psychiatry
- PMID
- 22265365
- DOI
- 10.1016/j.jaac.2011.11.004
- PMCID
- PMC3314954
OBJECTIVE: Recent epidemiologic studies have demonstrated that Tourette syndrome (TS) and chronic tic disorder (CT) are more common than previously recognized. However, few population-based studies have examined the prevalence of co-occurring neuropsychiatric conditions such as obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD). We evaluated the prevalence of TS, CT, and their overlap with OCD and ADHD in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. METHOD: A total of 6,768 children were evaluated using longitudinal data from mother-completed questionnaires. DSM-IV-TR diagnoses of TS and CT were derived using three levels of diagnostic stringency (Narrow, Intermediate, and Broad). Validity of the case definitions was assessed by comparing gender ratios and rates of co-occurring OCD and ADHD using heterogeneity analyses. RESULTS: Age 13 prevalence rates for TS (0.3% for Narrow; 0.7% for Intermediate) and CT (0.5% for Narrow; 1.1% for Intermediate) were consistent with rates from other population-based studies. Rates of co-occurring OCD and ADHD were higher in TS and CT Narrow and Intermediate groups compared with controls but lower than has been previously reported. Only 8.2% of TS Intermediate cases had both OCD and ADHD; 69% of TS Intermediate cases did not have either co-occurring OCD or ADHD. CONCLUSIONS: This study suggests that co-occurring OCD and ADHD is markedly lower in TS cases derived from population-based samples than has been reported in clinically ascertained TS cases. Further examination of the range of co-occurring neuropsychiatric disorders in population-based TS samples may shed new perspective on the underlying shared pathophysiology of these three neurodevelopmental conditions.
Study flow diagram. CT = chronic tics; SEN = Special Educational Needs statement; TS = Tourette syndrome.
LLM interpretation
This is a study flow diagram illustrating the subject selection process, starting from 14,472 subjects with known birth outcomes. It details the attrition through live births, survival at 1 year, and data availability at 13 years, followed by the exclusion of 384 subjects due to intellectual disability, autism, low IQ (<80), or SEN status. The final cohort of 6,768 eligible subjects is categorized into controls (5,968) and various narrow, intermediate, and broad subgroups of Tourette syndrome (TS) and chronic tics (CT).
Overlap of Tourette syndrome (TS)/chronic tics (CT), obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) diagnoses in the Avon Longitudinal Study of Parents and Children. (a) Comparison of overlap among TS, OCD, and ADHD cases using the TS Intermediate (TSi) definition. Note: Percentages indicate the fraction of subjects in each subgroup. Percentages on either side of the dotted line indicate the different fractional percent of individuals with overlapping conditions relative to the disorder of reference. For example, the five cases of TS+ADHD without OCD represent 10.2% of the total TS sample but only 3.1% of the ADHD sample. Similarly, the four TS+OCD+ADHD cases at the center of the diagram represent 8.2% of the TS sample but only 2.2% of the OCD and 2.5% of the ADHD samples, respectively. (b) Comparison of overlapping conditions between any chronic tic disorder (TS or CT), OCD and ADHD using the Intermediate case definitions of TS or CT (TSCTi).
LLM interpretation
This figure consists of two Venn diagrams (a and b) showing the overlap of diagnoses for Tourette syndrome/chronic tics (TSi/TSCTi), OCD, and ADHD. Each section contains the number of subjects and the corresponding percentage of the total for each disorder's reference group. The diagrams illustrate that while most individuals have a single diagnosis, there are overlapping subgroups, including a central intersection of individuals diagnosed with all three conditions.
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| Title | Year | PMID |
|---|---|---|
| Copy number variation in obsessive-compulsive disorder and tourette syndrome: a cross-disorder study. | 2014 | 25062598 |
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