DIFFERENCES IN CLINICAL CHARACTERISTICS BETWEEN TOURETTE SYNDROME PATIENTS WITH AND WITHOUT GENERALIZED TICS OR COPROLALIA

The purpose of this study is to examine whether there are differences in clinical characteristics between Tourette syndrome (TS) patients wi th and without 'generalized tics' (GT) which involve the entire body, and/or coprolalia. Subjects were 61 patients (55 males and 9 females, mean age, 17.4 +/- 7.2 years) who visited Tokyo University's outpatien t clinic of neuropsychiatry from 1974 to 1993 and who met criteria for Tourette's disorder of DSM-III-R. Data on clinical characteristics, i ncluding tic symptoms and courses of their development, complications and developmental histories, treatment and severity, were collected by systematic chart review of all subjects. Tourette syndrome patients ' generalized tics' tended to show multiple complex vocal tics more freq uently than TS patients without GT. Tourette syndrome patients with co prolalia tended to show significantly higher rates of copropraxia, ech olalia, and 'cleaning/washing' compulsion than did the TS patients wit hout coprolalia. Tourette syndrome patients with both GT and coprolali a were classified as the severest group in terms of tic symptoms and s ocial impairment. Tourette syndrome patients who had neither of these morbidities were classified into the mildest group in all aspects. Gen eralized tics and coprolalia seemed to indicate the severest end of th e TS spectrum and seemed to be related with a need of intensive treatm ent.