Clinical factors predicting tic persistence into adulthood

Despite widespread patient and family interest in long-term outcome prediction at the time of Tourette syndrome (TS) diagnosis, there is limited data on factors associated with disease severity and impairment in adulthood. This study aimed to examine the relationship between childhood and adulthood worst-ever tics and identify predictors of adulthood tic severity and impairment, including the role of significant life events.

In a cross-sectional design, 258 adult participants with TS completed an online questionnaire assessing tic severity and impairment during their worst-ever tic periods in childhood and adulthood, co-occurring obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) symptoms and clinical and demographic characteristics.

Worst-ever childhood tic severity and impairment were significantly associated with greater worst-ever adulthood tic severity and impairment. Co-occurring OCD was also associated with greater tic severity and impairment in adulthood. Use of tic medication was a significant predictor of greater worst-ever adulthood tic impairment, but not severity. Overall, 153 (59.3%) participants reported experiencing a significant life event at the time of their worst-ever tics in adulthood, and the presence of a significant life event was associated with greater worst-ever adulthood tic impairment. There was a significant effect of negative and neutral life events, but not positive life events, on adult worst-ever tic severity and impairment, compared to those not reporting a significant life event.

These findings provide insight into characteristics present either in childhood or in adulthood that may help predict the presence and severity of tic symptoms in adulthood.