Psychosocial outcome and psychiatric comorbidity

defined by motor and vocal tics that persist for 41 year. In addition to having tics, children with Tourette syndrome often function poorly across numerous psychosocial domains and have high rates of psychiatric comorbidity. The long-term course of Tourette syndrome is variable, but tics typically improve during adolescence such that by age 18 years, up to 90% of individuals with Tourette syndrome have only mild tics or none at all. It is unclear, however, whether their psychosocial functioning, like their tics, improves by this age. Previous longitudinal studies found that individuals with Tourette syndrome who were followed up in late adolescence or early adulthood functioned reasonably well, but these studies were limited by the absence of a control group. In contrast, controlled cross-sectional studies reported that adults with Tourette syndrome had poorer quality of life and more psychopathology, but a critical limitation was that the participants were not necessarily identified as having Tourette syndrome in childhood and were attending specialty clinics as adults. Consequently, the poor outcomes described may apply mainly to the minority of individuals with Tourette syndrome who continue to have prominent tics and pursue treatment for them in adulthood. Our objective, therefore, was to reassess in late adolescence a large sample of individuals who were identified as having Tourette syndrome in childhood and may or may not still be in treatment, and compare them with community controls with respect to psychosocial functioning and psychiatric illness. We selected a community control group because we wanted to address a question that is salient for parents of children who present clinically with Tourette syndrome: how will my child function compared with individuals in my community who do not have Tourette syndrome? Our a priori hypothesis was that individuals with Tourette syndrome in late adolescence would have lower scores on the Children’s Global Assessment Scale (CGAS). We also explored whether psychosocial outcomes and rates of psychiatric comorbidity were associated with the severity of tic, attention-deficit hyperactivity disorder (ADHD) or obsessive– compulsive disorder (OCD) symptoms.