Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome

Background Tourette syndrome (TS) is a neurodevelopmental disorder with frequent comorbidity with Attention-deficit-Hyperactivity disorder (ADHD). The impact of this association is still a matter of debate. Method Using the TIC database containing 6,805 cases, the clinical differences were ascertained between subjects with and without ADHD. Results The reported prevalence of ADHD in TS was 55%, within the range of many other reports. If the proband was diagnosed with ADHD, a family history of ADHD was much more likely. ADHD was associated with earlier diagnosis of TS and a much higher rate of anger control problems, sleep problems, specific learning disability, OCD, Oppositional-defiant disorder, mood disorder, social skill deficits, sexually inappropriate behaviour, and self-injurious behaviour. Subjects with seizures and with Developmental Coordination Disorder also had high rates of ADHD. Anxiety disorder, however, was not more frequent. Preliminary data suggest that most behavioural difficulties in ADHD are associated with the Combined or Hyperactive-Impulsive Subtypes of ADHD. Every large site (> 200 cases) had a significantly increased rate of anger control problems in cases with ADHD. Conclusion Subjects with TS have high rates of ADHD and complex associations with other disorders. Clinically the findings confirm other research indicating the importance of ADHD in understanding the behavioural problems often associated with the diagnosis of TS. Additional ADHD comorbidity should be taken into account in diagnosis, management, and training.