What are the signs and symptoms of attention deficit–hyperactivity disorder in Tourette syndrome (TS) and other tic disorders?

Updated: May 30, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
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Answer

Attention deficit–hyperactivity disorder (ADHD refers to a clinically defined syndrome beginning in childhood and characterized by inattention and distractibility, behavioral hyperactivity, or marked impulsivity.

In recent years, several important findings have emerged from studies of (nontic) ADHD. The reliability of ADHD diagnosis by experts compares well with that of most other medical illnesses.

Findings suggest that, like essential hypertension, ADHD as currently defined represents a clinically convenient threshold imposed on a unimodal population distribution of symptom severity. The syndrome is highly heritable whether the phenotype is defined by clinician diagnoses or parents' reports of symptoms. Finally, safe treatments of proven efficacy are available.

Clearly, ADHD is common in patients with TS seen by physicians. A Centers for Disease Control and Prevention (CDC) survey, 64% of TS patients had also been diagnosed with ADHD. To some extent, the prevalence may represent primarily referral bias; patients with uncomplicated tics are less likely to seek medical attention. However, ADHD is common even in epidemiologic samples of TS and in TS-affected relatives of pure-TS probands.

The genetic relationship of TS with ADHD is less clear than its relationship with OCD. [108] The clinical picture is similar to that observed in populations without tics.


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