The findings from a multisite, international database of 3500 individuals with Tourette syndrome (TS) from 22 countries are reported from the British Columbia Children’s Hospital, Vancouver, Canada. Males outnumbered female patients, the average male:female ratio being 4.3:1. Mean age at onset of tics is 6.4 years, and mean age at diagnosis is 13 years. Comorbidities are reported in 88%, and the most common is ADHD with TS (60%). Other comorbid symptoms include OCD (27%), CD/ODD (15%), mood disorder (20%), LD (23%), and stuttering (8%). Behavior problems, including anger control (37%), sleep difficulties (25%), self-injurious behavior (14%), and coprolalia (14%), are strongly correlated with comorbidity. [1]

COMMENT. A delay in diagnosis of tics and TS for 6 years was the rule in all sites sampled. The presence of comorbid symptoms such as ADHD should alert the clinician to the likelihood of associated behavior problems, especially anger control and sleep difficulties. Medication for tics had been prescribed in 60% of patients, but counseling and other therapeutic interventions could be indicated in those with associated behavior disorders.