Informativeness of structured diagnostic interviews in the identification of Tourette's disorder in referred youth

Although specialized programs have greatly advanced the treatment of youth with Tourette's disorder (TD), not all children with TD reach such programs , raising questions as to whether TD is adequately identified outside speci alized settings. There is thus a need for evidence that cases identified in the nonspecialty setting are "true cases." Because structured diagnostic i nterview methodology can reduce errors of omission, this approach can facil itate the identification of TD in referred youth outside specialized progra ms. Similarities between cases ascertained in specialty and nonspecialty se ttings would suggest that those identified in the nonspecialty setting were indeed "true cases." Comparisons were made between youth with TD ascertain ed through a specialized TD program who had both a structured diagnostic in terview-derived diagnosis of TD plus an expert evaluation of TD (N = 103), with youth ascertained through a non-TD specialized pediatric psychopharmac ology program who had a structured diagnostic interview-derived diagnosis o f TD (N = 92). Irrespective of ascertainment source, children with structur ed interview-derived diagnosis of TD shared similar correlates in terms of tic severity, mean age of onset and duration of ties, as well as patterns o f comorbidity well known to be associated with TD in clinical samples. Chil dren meeting diagnostic criteria for TD on structured diagnostic interviews share similarities and patterns of clinical correlates, irrespective of as certainment through a specialized TD or non-TD specialized clinic. These fi ndings support the usefulness of structured diagnostic interview methodolog y as a diagnostic aid for the identification of TD in non-TD specialized se ttings and facilitate delineation of patterns of comorbidity.