Tourette Syndrome and quality of life

http://www.ncbi.nlm.nih.gov/pubmed/22381812

Eur J Paediatr Neurol. 2012 Feb 28. [Epub ahead of print]
Predictors during childhood of future health-related quality of life in adults with Gilles de la Tourette syndrome.
Cavanna AE, David K, Orth M, Robertson MM.
Source
Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, United Kingdom; Department of Mental Health Sciences, UCL, London, United Kingdom; Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, United Kingdom.

Abstract
BACKGROUND:
Gilles de la Tourette syndrome (GTS) is a chronic neurodevelopmental disorder characterised by multiple motor and phonic tics and behavioural problems. Patients with GTS of all ages often report a poor health-related quality of life (HR-QOL). The diagnosis of GTS is usually established in childhood but little is known about factors that predict the long-term well-being of patients, especially in the presence of co-morbid behavioural problems.

AIM:
To investigate the childhood predictors of HR-QOL in a cohort of adult patients with GTS.

METHODS:
Forty-six patients with GTS aged 6-16 years underwent a baseline standardised clinical assessment of both tics and behavioural symptoms at a specialist GTS clinic. The same patients were re-assessed aged 16 years and above, with a mean follow-up period of 13 years (range 3-25 years), when they completed the Gilles de la Tourette Syndrome-Quality of Life Scale (GTS-QOL), a disease-specific measure of HR-QOL.

RESULTS:
Tic severity, premonitory urges and family history of GTS were identified as predictors during childhood of a poorer HR-QOL in adults with GTS by multiple linear regression analysis. Specifically, tic severity significantly predicted poor outcome across physical, psychological and cognitive domains of the GTS-QOL, reflecting widespread effects on HR-QOL.

CONCLUSION:
Young patients with severe tics associated with characteristic premonitory urges and a family history of tic disorders appear to be at higher risk for poorer HR-QOL as adults. Further prospective research into HR-QOL in GTS is required in order to inform long-term strategic resource allocation.