Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach

Eur J Neurol. 2014 May;21(5):700-7, e44-5. doi: 10.1111/ene.12274. Epub 2013 Oct 7.

Abstract

Background and purpose: Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities.

Methods: The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates.

Results: In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable.

Conclusions: To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.

Keywords: Gilles de la Tourette syndrome; epidemiology; latent class analysis; tic disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Depression / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / epidemiology
  • Phenotype
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Sex Characteristics*
  • Switzerland / epidemiology
  • Tic Disorders / classification*
  • Tic Disorders / epidemiology*
  • Tic Disorders / psychology