Tourette's syndrome and psychopathology in a child psychiatry setting

Prior investigations of psychopathology among children with Tourette's syndrome (TS) have rarely used child psychiatry samples and sophisticated personality instruments.

To produce an objectively derived composite TS personality profile and to determine the rate of particular problems in a TS psychiatry sample compared with children with out TS from the same clinical practice.

Children (n = 33) referred to child psychiatrists because of emotional and behavior problems who were subsequently also found to meet DSM-III-R criteria for TS were assessed by the Personality Inventory for Children.

Children with TS expressed high rates of psychopathology overall (composite 2.7 SD elevated) with depression, anxiety, and peculiar behavior having the highest values; depression occurred most frequently (73%), and attention-deficit hyperactivity disorder (55%) was no more common than among comparison group children and conduct problems (18%) were rarer. "Depression, anxiety, tension, and excessive worry" were characteristic of the actuarially derived modal TS personality.

The prevalence and manifestations of psychopathology of children with TS in a child psychiatry practice are not identical with those reported in the literature. Child psychiatrists should be particularly vigilant of depressive symptoms and expect to encounter relatively few conduct problems compared with children without TS. Establishing "local prevalence rates" for children with TS seeking psychiatric evaluation can help guide the diagnostician and make diagnosis more assured.