The effects of Gilles de la Tourette syndrome and other chronic tic disorders on quality of life across the lifespan: a systematic review

Abstract

Gilles de la Tourette syndrome (GTS) and other chronic tic disorders are neurodevelopmental conditions characterized by the presence of tics and associated behavioral problems. Whilst converging evidence indicates that these conditions can affect patients’ quality of life (QoL), the extent of this impairment across the lifespan is not well understood. We conducted a systematic literature review of published QoL studies in GTS and other chronic tic disorders to comprehensively assess the effects of these conditions on QoL in different age groups. We found that QoL can be perceived differently by child and adult patients, especially with regard to the reciprocal contributions of tics and behavioral problems to the different domains of QoL. Specifically, QoL profiles in children often reflect the impact of co-morbid attention-deficit and hyperactivity symptoms, which tend to improve with age, whereas adults’ perception of QoL seems to be more strongly affected by the presence of depression and anxiety. Management strategies should take into account differences in age-related QoL needs between children and adults with GTS or other chronic tic disorders.

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

“…We set out to investigate self-concept and its determinants in a clinical sample of adolescents and young adults with GTS. This was the first study to focus on late adolescence: we hypothesised that patients with GTS in this age group experience problems with self-concept related to co-morbid conditions (19) and assessed their clinical correlates with a comprehensive battery of psychometric instruments. (1) .…”

Child and adolescent psychiatry in ICD-11: an opportunity to overcome mistakes made in DSM-5?

“…As mentioned in the first article of the present issue of ECAP by Evans et al [3] TD are neurodevelopmental conditions not only characterized by the presence of tics but also of associated behavioral problems. While quality of live (QoL) profiles in children often reflect the impact of comorbid ADHD symptoms, adults' QoL seems to be more strongly affected by comorbid depression and anxiety.…”

“…Furthermore, even the core aims of some of the articles directly pertain to questions related to the diagnostic classification. For example, Algorta et al [1] aimed to improve the diagnostic efficiency of the parent-rated Strengths and Difficulties Questionnaire (SDQ) to identify attention deficit hyperactivity disorder (ADHD) by developing scoring weights for clinical practice in a representative sample for the United Kingdom.While some articles of the present issue deal with diagnoses such as tic disorders [3] or anorexia nervosa [10] that have a good clinical diagnostic accuracy, some of the other articles are based on less reliable and valid diagnoses and therefore are more dependent on the quality of the respective classification system [e.g., 4, 13]. The quality of these systems, also known as psychiatric nosology or taxonomy, is still an ongoing matter of debate and research, because the search for biomarkers of mental disorders continues to be a very demanding challenge even if we recognize that "behavior is a biomarker just as objective as pulse or cardiac ejection fraction, albeit much harder to measure" [12].…”

“…While some articles of the present issue deal with diagnoses such as tic disorders [3] or anorexia nervosa [10] that have a good clinical diagnostic accuracy, some of the other articles are based on less reliable and valid diagnoses and therefore are more dependent on the quality of the respective classification system [e.g., 4,13]. The quality of these systems, also known as psychiatric nosology or taxonomy, is still an ongoing matter of debate and research, because the search for biomarkers of mental disorders continues to be a very demanding challenge even if we recognize that "behavior is a biomarker just as objective as pulse or cardiac ejection fraction, albeit much harder to measure" [12].…”

“…Moreover, in several patients the latter are still present but either under recognized or not sufficiently reported. For diagnostic and treatment decisions it has to be considered that on average even subclinical comorbid problems have a greater impact on QoL than the tics themselves (see this issue [3]) [15]. Therefore, this classification has to be regarded as a step backwards.…”