Table 1

Comorbidity and/or psychopathology in Tourette syndrome: the suggested relationships (modified and updated from Robertson 2003; 2011)

Comorbidity and/or psychopathologyHow common in GTS?AetiologyCommentsReferences
1Attention deficit hyperactivity disorderVery commonNot geneticAlso common in clinic, community and epidemiological studiesRobertson30
2Obsessive compulsive behaviours/symptoms/disorderVery commonIntegral part of GTS; genetically linkedOCB/OCS=egosyntonic; OCD=egodystonicRobertson31
3Autistic spectrum disorders6–11%Unsure—probably non- specific and as poor general neurodevelopmentRecent studies suggest similar genetics in some casesRobertson4
4Depression13–76%Multi-factorial; not geneticControlled studies=GTS>depressedRobertson32
5AnxietyCommonSecondary to having GTSRobertson28
6Impulsivity and rage (not ADHD criteria)CommonUnknown; more research requiredBudman et al126
7Self-injurious behaviours30%Difficult clinical problem to treatRelated to OCB/D; related to impulsivityRobertson et al127 Mathews et al128
8Personality disordersCommonProbably related to childhood ADHD, ODD, CDWhole spectrum of PDs: not restricted to OCPDRobertson et al129
9Conduct disorder; oppositional defiant disorderReferral biasRobertson28
10SchizophreniaRareUnrelated; chance associationRobertson28
11Bipolar affective disorderUncommonProbably related to OCD and ADHD not GTS per seRobertson28
12DysphoriaCommonAdverse side effects of anti-GTS medicationsMay require adding antidepressant discontinuation of RxRobertson28
13School phobia/separation; anxietyCommonAdverse side effects of anti-GTS medicationsMay require discontinuation and treatment in own rightRobertson28
14‘Cognitive dulling’Fairly commonAdverse side effects of anti-GTS medicationsPatients receiving neuroleptics=lower IQRobertson et al130
15DementiaNilNo associationn/a
Total comorbidity and/or psychopathology88–90% of all GTS patientsMixedClinical and epidemiologicalFreeman et al29 Khalifa and von Knorring8 9
  • ADHD, attention deficit hyperactivity disorder; CD, conduct disorder; GTS, Gilles de laTourette syndrome; na, not applicable; OCPD, obsessive compulsive personality disorder; ODD, oppositional defiant disorder; PDs, personality disorders; Rx, treatment.