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The Behavioral Spectrum of Gilles de la Tourette Syndrome

Received October 12, 2007; revised January 14, 2008; accepted January 18, 2008. Dr. Cavanna is affiliated with the Sobell Department of Movement Disorders, Institute of Neurology, in London, with the Department of Neuropsychiatry, BSMHFT and University of Birmingham, and with the Department of Neurology at Amedeo Avogadro University in Novara, Italy; Drs. Servo and Monaco are also affiliated with the Department of Neurology at Amedeo Avogadro University in Novara; Prof. Robertson is affiliated with the Department of Mental Health Sciences at University College London and with the Department of Neurology, St Georges Hospital and Medical School in London. Address correspondence to Andrea E. Cavanna, M.D., Department of Neurology, Amedeo Avogadro University, Corso Mazzini 18, 28100 Novara, Italy; a.cavanna{at}ion.ucl.ac.uk (e-mail).

Gilles de la Tourette syndrome is a neurodevelopmental disorder consisting of multiple motor and one or more vocal/phonic tics. Tourette’s syndrome is increasingly recognized as a common neuropsychiatric disorder usually diagnosed in early childhood, and comorbid neuropsychiatric disorders occur in approximately 90% of patients; the most common of these are attention deficit hyperactivity disorder and obsessive-compulsive disorder. Depression is also common, with a lifetime risk of 10% of patients. Moreover, a high prevalence of personality disorders has been reported in preliminary investigations on Tourette’s syndrome populations. This paper provides an updated review of the literature on the multifaceted phenotype of Tourette’s syndrome, with special attention to the behavioral problems and the relationship between Tourette’s syndrome and comorbid neuropsychiatric conditions. The issue of whether Tourette’s syndrome should still be considered as a unitary nosological entity is also addressed.

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