School Problems in Tourette's Syndrome

Abwender, David A.; Como, Peter; Kurlan, Roger; Parry, Kevin; Fett, Kristi A.; Cui, Lu; Plumb, Sandra; Deeley, Cheryl

doi:10.1001/archneur.1996.00550060051016

Cited by 75 publications

(47 citation statements)

References 4 publications

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“…A study of 138 youths aged 5 to 18 years showed that 46% of children with GTS demonstrate school-related problems. Of note, patients with co-morbid ADHD had a nearly 4-fold increased risk for academic difficulty compared to those without AD-HD [16]. Consistent findings have shown that much of the psychosocial and behavioural dysfunction in children with tic disorders appears to be a consequence of co-morbid ADHD, which is highly associated with disruptive behaviour and functional impairment [17][18][19][20].…”

Section: The Functional Impact Of Gilles De La Tourette Syndrome Acromentioning

confidence: 73%

Health-Related Quality of Life in Gilles de la Tourette Syndrome: A Decade of Research

Cavanna

David

Bandera

et al. 2013

Behavioural Neurology

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Abstract. Gilles de la Tourette syndrome (GTS) is a neurodevelopmental condition characterised by multiple motor and phonic tics and associated behavioural problems, carrying a significant burden on patients' lives. Although the term health related-quality of life (HR-QOL) has only been used in recent years, several studies have long addressed the impact of GTS on physical, psychological and social aspects of wellbeing of both children and adults with GTS. We set out to answer the question "Is HR-QOL affected by GTS and, if so, in what domains?" by conducting a systematic literature review of published original studies addressing HR-QOL in both children and adult patients with GTS. This review focuses on the current evidence on the impact of GTS on patients' lives, mainly informed by studies using generic functional impairment and HR-QOL measures from the last decade, and expands on the new opportunities introduced by the recently developed GTS-specific HR-QOL scales (GTS-QOL and GTS-QOL-C&A). Analysis of the first decade of studies specifically addressing HR-QOL in GTS suggests that co-morbid conditions are key factors in determining HR-QOL in young patients, whilst the picture is more complex in adults with GTS. These findings offer some general directions for both current clinical practice and future research. Keywords: Gilles de la Tourette syndrome, health-related quality of life, functional impairment, tics, behavioural problems The functional impact of Gilles de la Tourette syndrome across the lifespanGilles de la Tourette syndrome (GTS) is a life-long neurodevelopmental disorder defined by the presence of multiple motor and phonic tics [1]. Tics are repetitive, uncontrollable movements or vocalizations that usually present in childhood but may change with re- * Corresponding author: Dr. Andrea Eugenio Cavanna, MD, PhD., Department of Neuropsychiatry, The Barberry National Centre for Mental Health, 25 Vincent Drive, Birmingham B15 2FG, UK. Tel.: +44 0121 3012317; Fax: +44 0121 3012291; E-mail: cavanna77@tin.it. gard to their location, frequency and severity over time [2]. GTS affects approximately 1% of school-age youngsters and is three to four times more common in males than females [3]. GTS is increasingly recognised as a complex disorder, with a wide spectrum of associated behavioural problems that can accompany the motor and phonic tics. These problems include ticrelated symptoms (ranging from socially inappropriate statements to actual self-harm) and co-morbid psychiatric disorders, such as obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) [4,5]. Large studies conducted both in clinical populations [2,6] and in the community [7] have consistently found that only about 10% of individuals with GTS do not present with behavioural co-morbidities.

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Section: The Functional Impact Of Gilles De La Tourette Syndrome Acromentioning

confidence: 73%

Health-Related Quality of Life in Gilles de la Tourette Syndrome: A Decade of Research

Cavanna

David

Bandera

et al. 2013

Behavioural Neurology

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“…Tics can impair everyday activities (including job and school attendance) and social relationships (10) . School functioning is often compromised, especially in young patients with co-morbid ADHD (11) . Although co-morbid ADHD is known as the main cause of social and behavioural difficulties in this patient population (12) , affective symptoms have consistently been shown to be a major determinant of patients' wellbeing, as a considerable proportion of patients with GTS receive a formal diagnosis of affective disorder, irrespective of being diagnosed with ADHD, throughout adolescence (13) and adulthood (14) .…”

Section: Introductionmentioning

confidence: 99%

A preliminary examination of self-concept in older adolescents and young adults with Gilles de la Tourette syndrome

Silvestri

Chiarotti

Baglioni

et al. 2017

European Journal of Paediatric Neurology

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Gilles de la Tourette syndrome (GTS) is a childhood-onset neuropsychiatric disorder characterised by multiple tics and often associated with behavioural problems. Although there is evidence of significantly reduced self-esteem in children and adolescents with GTS, little is known about perceived self-concept and its clinical determinants at the transition age between adolescence and adulthood. We therefore set out to investigate self-concept in a clinical sample of young patients with GTS at this crucial age for personal development. In addition to standard demographic and clinical data, we collected self-ratings using a standardised battery of psychometric instruments, as well as the Multidimensional Self Concept Scale, a comprehensive questionnaire developed to assess self-concept in subjects aged 9 to 19 years, tapping into the social, competence, affect, academic, family, and physical domains. We found that patients diagnosed with at least one comorbid psychiatric disorder ("GTS-plus" phenotype) reported significantly lower self-concept than patients with "pure GTS", whereas tic-related variables had no impact on self-concept. Anxiety symptoms were the main determinants of self-concept, especially trait anxiety with regard to social and affective domains. Affective symptoms could also have a negative impact on the physical, affective, competence, and social domains of self-concept. Routine screening for these co-morbid conditions should be recommended in all patients with GTS seen at transition clinics from paediatric to adult care, in order to implement effective treatment interventions whenever possible.

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“…Besides ADHD, other factors contributing to poor academic performance in children with and without TD include other neuropsychiatric comorbidities, sedative effects of drugs, intellectual disability, and specific socio-cultural and home-environmental characteristics [6,7]. …”

Section: Introductionmentioning

confidence: 99%

The Association of Poor Academic Performance with Tic Disorders: A Longitudinal, Mainstream School-Based Population Study

Cubo¹,

González²,

Ausín³

et al. 2017

Neuroepidemiology

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Background: Little is known about the academic performance of students with tic disorders (TD). Our aim was to investigate the association of TD and poor academic performance over time. Methods: Longitudinal, observational study of mainstream schoolchildren comparing grade retention (GR) and learning disorders (LD) in students with vs. without TD between 2010 and 2014. Students with vs. without TD based on DSM-IV-TR criteria, or with vs. without GR and LD were compared in terms of comorbidities, school, and environmental characteristics. The association of TD with GR was analyzed using hazard ratios (HRs) with 95% CIs, and with LD using logistic regression analysis [Odds ratio (OR)]. Results: Two hundred fifty-eight students were included (mean age 14.0 ± 1.71 years, 143 [55.4%] males). The incident rate for TD and GR was 2.6 and 3.3 per 100 persons-year, respectively. LD found in 21 (9.9%) students was associated with TD (OR 11.62, 95% CI 2.21-60.90, p = 0.004), and attention deficit hyperactivity disorder (ADHD; OR 6.63, 95% CI 1.55-28.37, p = 0.01). Low psychological support (HRs 12.79, 95% CI 3.39-48.17) and low sport participation (HRs 6.41, 95% CI 1.54-26.78) were risk factors for GR. Conclusions: TD was associated with academic difficulties, namely, LD in conjunction with ADHD but not GR. The diagnosis of TD and comorbidities, and the initiation of proper treatment could have a favorable impact on school performance, and consequently on social development.

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School Problems in Tourette's Syndrome

Abstract: Tics represented the primary reason for referral, but did not emerge as a significant predictor of academic problems. Rather, school-related difficulties appeared to be strongly associated with comorbid attention-deficit hyperactivity disorder.

Cited by 75 publications

References 4 publications

Health-Related Quality of Life in Gilles de la Tourette Syndrome: A Decade of Research

Health-Related Quality of Life in Gilles de la Tourette Syndrome: A Decade of Research

A preliminary examination of self-concept in older adolescents and young adults with Gilles de la Tourette syndrome

The Association of Poor Academic Performance with Tic Disorders: A Longitudinal, Mainstream School-Based Population Study

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