Can Childhood Comorbidities Be Good Predictors of Functional Outcome in Adults with Tourette Syndrome? A Series of 140 Cases (P02.061)

OBJECTIVE: Individuals with Tourette syndrome (TS) often display co-morbid symptoms of attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). The aim of the study was to examine the factors that predict the long-term functional outcome of patients with TS, especially with co-morbid behavioral problems. BACKGROUND: Tourette syndrome (TS) is a childhood-onset neuropsychiatric condition characterised by multiple motor and phonic tics. Comorbid behavioural problems are common, especially ADHD or OCD or both. Little is known about the long-term prognosis of TS associated with these comorbidities. DESIGN/METHODS: Retrospective chart review of over 30 years (1981- 2011). Inclusion: Cases satisfying TS core diagnostic criteria seen in pediatric neurology clinic and followed up as adult. Exclusion: other neurological findings, abnormal neuroimaging or metabolic studies. Cases were reviewed for age, sex, family history, tic characteristics, associated ADHD or OCD, level of education, occupation and marital status. The patients were divided into Group A (TS with ADHD or OCD) and Group B (TS without ADHD or OCD). Adults with education of college degree, married and employed were considered to have good functional outcome. RESULTS: Of 140 patients seen in TS clinic, 113 were males and 27 were females. Mean age of symptom onset was 8.5 years. Of all cases, 55 had mild, 71had moderate, 14 had severe tics. Group A: 95 cases (67%), mean age 8 year, 85 males. Of them 40 (42%) were college graduates, married and employed. Group B: 45 cases (33%), mean age 10 year, 28 males. Of them 16 (35%) were college graduates, married and employed. There was no statistically significant difference in functional outcome between group A and group B. CONCLUSIONS: In TS associated co-morbidities (ADD or OCD) do not predict functional outcome in adults compared to those without co-morbidities, however, further comprehensive age specific assessment of functional impairment in larger population might be necessary. Disclosure: Dr. Mainali has nothing to disclose. Dr. Velander has nothing to disclose. Dr. Lederman has nothing to disclose. Dr. Erenberg has nothing to disclose.