Prevalence and clinical correlates of self-injurious behavior in Tourette syndrome

Tourette syndrome (TS) is a neurodevelopmental condition characterized by the presence of multiple tics. In addition to common behavioral co-morbidities such as obsessive-compulsive disorder and attention-deficit and hyperactivity disorder, patients with TS can present with self-injurious behavior (SIB): deliberate, non-accidental, repetitive infliction of self-harm without suicidal intent. In order to determine the prevalence and clinical correlates of SIB in TS, we conducted a systematic literature review in accordance to the methodology described in the MOOSE Guidelines for Meta-Analysis and Systematic Reviews of Observational Studies in Epidemiology. The literature search yielded 20 cohort studies that were suitable for quantitative synthesis. Combined results showed that SIB is present in 35 % of patients with TS. Obsessive-compulsive behaviors appear to be associated with SIB in patients with TS, and their presence should alert clinicians to the possible co-occurrence of SIB, particularly if the patient has multiple behavioral co-morbidities. Since the reviewed studies were methodologically heterogeneous and were conducted in specialist clinics, our findings cannot be generalized to patients with TS in the wider community.