Anxiety disorders and tic severity in juveniles with Tourette's disorder

Objective: It was hypothesized that comorbidity with anxiety disorders woul d predict tic severity in youths with Tourette's disorder (TD). Method: Sub jects were 190 youths meeting DSM-III-R diagnostic criteria for TD who were consecutively referred to a pediatric psychopharmacology program between 1 994 and 1997. Subjects were initially evaluated with a clinical interview a nd the Schedule for Affective Disorders and Schizophrenia for School-Age Ch ildren-Epidemiologic version. Statistical analysis used t tests, chi(2) tes ts, and logistic regression analysis. Results: One hundred thirty-four subj ects were classified as mild/moderate and 56 as severe TD cases. No meaning ful differences were found in socioeconomic status, gender distribution, or age at onset of TD between the 2 groups. The 2 groups could not be differe ntiated by the presence of comorbid mood or disruptive behavior disorders i ncluding attention-deficit hyperactivity disorder. Although obsessive-compu lsive disorder (OCD) was overrepresented among the severe SD cases, the dif ference failed to reach statistical significance. Excluding social and simp le phobias, all other anxiety disorders were more clearly overrepresented a mong subjects with severe TD; separation anxiety disorder most robustly pre dicted tic severity, irrespective of the presence of OCD or other anxiety d isorders. Conclusion: Findings suggest that non-OCD anxiety disorders in ge neral and separation anxiety disorder in particular may be significantly as sociated with tic severity in referred TD patients.