Tourette syndrome and socioeconomic status

Tourette syndrome (TS) is a neurodevelopmental disorder characterised by multiple motor and vocal tics. Co-morbid behavioural problems are common and include obsessive-compulsive disorder, attention-deficit and hyperactivity disorder, depression and anxiety. Both tics and behavioural symptoms tend to have a chronic course and can affect patients' health-related quality of life; however, little is known about the relationship between TS, social status and occupation. We conducted an exploratory study on a clinical sample of 137 adult patients with TS to investigate the association between the core features of TS (both tic severity ratings and behavioural co-morbidities) and socioeconomic class. Both clinician- and patient-reported tic severity ratings were significantly higher amongst unemployed patients, compared to patients in the highest socioeconomic class (P = 0.004 and P < 0.001, respectively). There were no significant differences in socioeconomic class distribution between patients with TS and co-morbid behavioural problems ('TS plus', n = 88) and patients with uncomplicated TS ('pure TS', n = 49) (P = 0.205). Our findings suggest that higher tic severity can have far-reaching consequences on patients' life, as it appears to be selectively associated with unemployment and lower socioeconomic status. These observations prompt further research into the complex relationship between TS and social status.