CASE-STUDY - COMORBIDITY AMONG TOURETTES-SYNDROME, AUTISTIC DISORDER,AND BIPOLAR DISORDER

Objective: Several studies report a greater than expected concurrence for Tourette's syndrome (TS) with autistic disorder (AD). TS and bipol ar disorder (BD) also may co-occur at a greater than expected rate. Th e authors assess whether there is a greater than expected concurrence for TS+AD+BD. Method: Four patients who had at some time in their live s diagnoses of TS, AD, and BD were identified. Three of these had conc urrent TS+AD+BD. Diagnoses were made according to DSM-III-R criteria. Each of these patients was living in North Dakota and was in the autho rs' care at the time of this study. Results: The point prevalence (ris k) for concurrent. TS+AD+BD in North Dakota is not less than 4.6 x 10( -6). The developmental sequence of syndromes in these four patients wa s AD, then TS and then BD. Data from the authors' previously published , population-based prevalence studies indicate that TS+AD+BD co-occur at a greater than chance expectation. Conclusions: Common etiological factors may be involved in the greater than chance concurrence of TS+A D+BD.