Risky Impulsive Behavior in Gilles de la Tourette Syndrome

Background/Objectives: Behavioral disturbances are common in Gilles de la Tourette syndrome (GTS) and can include risky impulsive behaviors (RIBs), but RIB classification remains unclear. This study aims to define the epidemiology of RIB in GTS and to assess its relationship with tic severity and the prevalence of comorbid psychiatric disorders. Methods: The study was structured as a cross-sectional registration study, with each patient enrolled into the database during a single clinical visit. The study included 365 participants with GTS (272 males, 74.5%), of whom 278 (76.2%) were children and adolescents. The mean age at evaluation was 14.4 ± 9.8 years (range 4-64). Clinical data on RIB were obtained during routine outpatient visits using semi-structured questionnaires developed by the authors. Results: RIB was reported in 64 (17.6%) patients with GTS, a group composed of 19 (29.7%) adults and 45 (70.3%) minors. RIB commenced at a mean age of 8.1 ± 5.4 years (range 2-30). The mean age at onset of RIB was 2.6 ± 4.9 years after the onset of tics. Of the patients with RIB, 84.4% had at least one comorbid psychiatric disorder, whereas 15.6% of RIB patients had no psychiatric comorbidity. Multivariable logistic regression showed significant associations between RIB and YGTSS (p = 0.02, OR = 1.02), ADHD (p < 0.01, OR = 2.91), and ODD (p = 0.01, OR = 3.02). Conclusions: RIB may occur early in the course of GTS, typically beginning during childhood, and was identified in 17.6% of patients. Its occurrence was associated with the presence of comorbid psychiatric disorders, particularly ADHD and ODD. Greater tic severity was also statistically associated with RIB, although the effect was small and of limited clinical significance.