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Gilles de la Tourette Syndrome and Disruptive Behavior Disorders: Prevalence, Associations, and Explanation of the Relationships
Mary M. Robertson, M.B.Ch.B., M.D., D.Sc. (Med.); Andrea E. Cavanna, M.B.Ch.B., M.D., Ph.D.; Valsamma Eapen, M.B.B.S., Ph.D., F.R.C.Psych.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;:. doi:10.1176/appi.neuropsych.13050112
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From the University College London; the Dept. of Neurology, Atkinson Morley Wing, St. Georges Hospital and Medical School, London; the Dept. of Neuropsychiatry, BSMHFT and University of Birmingham, United Kingdom; the School of Life and Health Sciences, Aston University, Birmingham, United Kingdom; the Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London; the School of Psychiatry and Ingham Institute, University of New South Wales, Sydney, Australia; and the Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia.

Send correspondence to Valsamma Eapen; e-mail: v.eapen@unsw.edu.au

Received May 22, 2013; Revised September 29, 2013; Accepted October 28, 2013.

Abstract

Gilles de la Tourette syndrome and conduct disorder (CD) are both heterogeneous childhood onset conditions, and although patients with CD have been described in Gilles de la Tourette syndrome cohorts, little is known about the etiology of CD in Gilles de la Tourette syndrome or of the interrelationships. A cohort of 578 consecutive patients with Gilles de la Tourette syndrome was assessed using standard assessment protocols. A total of 13.5% of participants had only Gilles de la Tourette syndrome, whereas the rest had associated comorbidities and psychopathology. CD occurred in 14.5% of Gilles de la Tourette syndrome probands. These findings suggest that CD is not an integral part of Gilles de la Tourette syndrome but rather that CD in the context of Gilles de la Tourette syndrome is related to the presence of attention deficit hyperactivity disorder, as well as, and importantly, a family history of aggressive and violent behavior and forensic encounters.

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TABLE 1.Descriptive Characteristics of the Sample
Table Footer Note

Given some cases of missing data, percentages are calculated on different sample sizes (mean=360). ADHD, attention deficit hyperactivity disorder; CD, conduct disorder.

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TABLE 2.Tourette Syndrome, CD, and Related Characteristics
Table Footer Note

Percentages reported are for column totals. CD: conduct disorder; CI: confidence interval; FH Depression: family history for depression; FH Forensic: Family history for forensic encounters; OCD/OCB: obsessive compulsive behaviors/disorder; OR: odds ratio.

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a Chi-square test with Yates continuity correction.

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TABLE 3.Tourette Syndrome, Oppositional Defiant Disorder, and Related Characteristics
Table Footer Note

Percentages reported are column for column totals. CI: confidence interval; FH Depression: family history for depression; FH Forensic: family history for forensic encounters; OCD/OCB: obsessive compulsive behaviors/disorder; ODD: oppositional defiant disorder: OR: odds ratio.

Table Footer Note

a Chi-square test with Yates continuity correction.

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TABLE 4.Differences in Tic Severity Between Patients With Tourette Syndrome Affected and Not Affected by Comorbid Disruptive Behavioral Problems
Table Footer Note

CD: conduct disorder; ODD: oppositional defiant disorder.

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