anxiety – panic the most disabling psychiatric conditions associated with Tourette syndrome

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Researchers from the University at Buffalo’s School of Medicine and Biomedical Sciences assessed patients with Tourette syndrome to see if they could identify factors that would contribute to psychosocial and occupational disabilities as a result of vocal tics, a common characteristic of Tourette syndrome.

The results of the study, based on the Global Assessment of Functioning (GAF) scale, will be used to identify patients who are more likely to have or develop significant disabilities related either to the severity of their tics, or to the psychiatric disorders associated with Tourette syndrome such as obsessive-compulsive disorder, mood disorders and drug or alcohol abuse.

“Our study identified the most significant predictors of disability” said Dr. David G. Lichter, first author of the study.

The study involved 45 adult male and 21 adult female patients suffering from Tourette syndrome.

The results revealed that 32 percent had been diagnosed with obsessive compulsive disorder but 62 percent showed obsessive compulsive disorder behaviour.

Almost 29 percent had an anxiety or panic disorder and another 21 percent had symptoms of anxiety.

According to Dr Lichter, it was unexpected to find anxiety and panic as the most disabling psychiatric condition associated with Tourette syndrome and not something like depression.

“The main surprise was that depression was not a major predictor of psychosocial or occupational disability in these patients. Depression has been identified as an important predictor of quality of life in TS,” said Lichter.

Tourette syndrome is a neuropsychiatric disorder that begins in childhood and which is characterised by motor tics like muscle spasms, eye blinking, head jerking, leg kicking and facial twitches, and vocal tics like throat clearing, humming, whistling, and sometimes involuntary swearing.

In most Tourette sufferers, the tics decrease after adolescence, however, as Dr Lichter notes, the results of this study suggests that in those whose tics persist beyond adolescence, it is the severity of the tics that remains the primary factor contributing to global psychosocial and occupational disability.

“In many TS adults, motor tics remain more enduring and prominent than vocal tics and, in our study, motor tics were more severe overall than vocal tics and were more closely correlated with GAF scale score” said Dr Lichter.

The results of the study were presented at the 14th International Congress on Parkinson’s Disease and Movement Disorders, in Buenos Aires, Argentina.

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