There is clear evidence that tic disorders (TDs) are associated with psychosocial stress as well as emotional and behavioral problems. Studies have shown that individuals with TDs have higher acute physiological stress responses to external, single stressors (as reflected by saliva cortisol). The aim of the present study was to examine a physiological marker of longer-term stress (as reflected by hair cortisol concentration) in children and adolescents with TDs and unaffected siblings of individuals with TDs.Two samples of a European cohort were included in this study. In the COURSE sample, 412 children and adolescents aged 3-16 years with a chronic TD including Tourette syndrome according to DSM IV-TR criteria were included. The ONSET sample included 131 3-10 years old siblings of individuals with TDs, who themselves had no tics. Differences in hair cortisol concentration (HCC) between the two samples were examined. Within the COURSE sample, relations of HCC with tic severity and perceived psychosocial stress as well as potential effects and interaction effects of comorbid emotional and behavioral problems and psychotropic medication on HCC were investigated.There were no differences in HCC between the two samples. In participants with TDs, there were no associations between HCC and tic severity or perceived psychosocial stress. No main effects of sex, psychotropic medication status and comorbid emotional and behavioral problems on HCC were found in participants with TDs.A link between HCC and TDs is not supported by the present results.
Abstract This study investigated whether vitamin D is associated with the presence or severity of chronic tic disorders and their psychiatric comorbidities. This cross-sectional study compared serum 25-hydroxyvitamin D [25(OH)D] (ng/ml) levels among three groups: children and adolescents (3–16 years) with CTD ( n = 327); first-degree relatives (3–10 years) of individuals with CTD who were assessed for a period of up to 7 years for possible onset of tics and developed tics within this period ( n = 31); and first-degree relatives who did not develop tics and were ≥ 10 years old at their last assessment ( n = 93). The relationship between 25(OH)D and the presence and severity of tics, as well as comorbid obsessive–compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), were analysed controlling for age, sex, season, centre, latitude, family relatedness, and comorbidities. When comparing the CTD cohort to the unaffected cohort, the observed result was contrary to the one expected: a 10 ng/ml increase in 25(OH)D was associated with higher odds of having CTD (OR 2.08, 95% CI 1.27–3.42, p < 0.01). There was no association between 25(OH)D and tic severity. However, a 10 ng/ml increase in 25(OH)D was associated with lower odds of having comorbid ADHD within the CTD cohort (OR 0.55, 95% CI 0.36–0.84, p = 0.01) and was inversely associated with ADHD symptom severity ( β = − 2.52, 95% CI − 4.16–0.88, p < 0.01). In conclusion, lower vitamin D levels were not associated with a higher presence or severity of tics but were associated with the presence and severity of comorbid ADHD in children and adolescents with CTD.
Tourette Syndrome (TS) is a neurodevelopmental disorder presenting with motor and vocal tics. Although TS influences the everyday life of children, we only have fragmented knowledge on the topic of the developmental and comorbidity profile, symptom severity and genetical/environmental background. The aim of this article is to present the demographical characteristics, comorbidity profile and the tic symptom types and severity of patients from the Tourette Syndrome Outpatient Clinic of Vadaskert Child and Adolescent Psychiatry Hospital, Budapest.Our sample consists of all the patients (N=137), who visited the Tourette Syndrome Outpatient Clinic between February, 2012, and July, 2013. Patients were in the age range of 3 to 18 years. We recorded demographical and tic-specific data (age, symptom onset, TS in the family, comorbidity, adverse pre-/peri-/postnatal events) of the participants, and administered the Yale Global Tic Severity Scale (YGTSS).The average age at symptom onset was 5.9 years. Average symptom severity (measured by the YGTSS) was 22.4 points. Comorbid Attention Deficit and Hyperactivity Disorder (ADHD) was reported in 31%, Obsessive-Compulsive Disorder (OCD) in 10%, and Autism Spectrum Disorders (ASD) in 10% of the sample. The most common tic types were simple head tics (blinking, shaking of head). Symptom severity correlated positively with age (p <0.05), but not with gender, age at symptom onset, positive family history for TS, or adverse pre-, peri-, and postnatal events.The characteristics of our sample does not show any major differences from international reports of similar samples. Comorbidity is an exception: our sample shows lower rates of comorbidities than usually reported.
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