Objective: This study sought to understand how the presence, severity and treatment of Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD)  influence tic severity and the need for treatment of tics.

Background: While both ADHD and OCD comorbidity in individuals with Tourette Syndrome (TS) have major impacts on psychosocial quality of life, there is comparatively little data on how the presence of ADHD and OCD influence tic severity and the need for treatment. 

Methods: Participants in the study were children seen at a single specialty clinic. Differences in the Yale Global Tic Severity Scale (YGTSS) score by treatment status, sex, ADHD diagnosis and treatment, presence of Obsessive Compulsive Behaviours (OCBs), OCD diagnosis and treatment were analyzed. Correlations between YGTSS total tic scores and age, ADHD and OCD severity were examined. Associations between treatment for tics and ADHD diagnosis, medical treatment for ADHD, presence of OCBs, OCD diagnosis and treatment of OCD were studied.

Results: There were 114 children in the sample, with a mean age of 10.25 years.  A diagnosis of comorbid ADHD was present in 39%; OCBs in 35%; and OCD in 7%.  The mean total tic severity score on the YGTSS was 17.10 points. There was no difference in YGTSS scores between children diagnosed with versus without ADHD. YGTSS scores were significantly higher in children with OCBs by 4.13 points (95% CI 0.78-7.47, p=0.008). Evaluation of Spearman correlations revealed a borderline positive correlation between the YGTSS total tic score and the Conners’ Parent Report Hyperactivity T-score (Spearman’s rho 0.227, p=0.016). Analysis of covariance examining the relationship between YGTSS total tic score and all covariates revealed a significant relationship only with age and treatment for tics.Children with a comorbid ADHD diagnosis were more likely to be treated for their tics, with an odds ratio of 3.51 (95% CI 1.37-8.95). 

Conclusions: This study demonstrates that tic severity in children is most strongly associated with age, and the presence of obsessive compulsive behaviours.  The treatment of tics early in the course of the disorder is most strongly associated with ADHD, and as tic severity does not appear to be greater in these children, may relate to the greater overall psychosocial impairment in children with this comorbidity.   

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/tic-severity-and-treatment-in-children-the-effect-of-comorbid-attention-deficit-hyperactivity-disorder-and-obsessive-compulsive-behaviours/