“It’s a curse!”: Coprolalia in Tourette syndrome

Background and purpose: Coprolalia is a complex socially inappropriate vocal tic most frequently reported in the context of Tourette syndrome (TS) and widely portrayed as a cardinal characteristic of this condition throughout popular culture. This study investigated which clinical factors may predispose some patients with TS to experience coprolalia and the impact of this symptom on quality of life. Methods: Participants were 60 patients with TS (39 males, mean age 32.15, SD 14.1 years) of whom 50% reported mental coprolalia (urges) and 33% reported actual involuntary swearing as a tic. Relationships between the presence of coprolalia and a range of clinical variables including severity of tics, obsessive-compulsive symptoms, attention problems, anxiety, depression, premonitory urges for tics and quality of life were investigated. Results: The presence of urges to utter obscene language was significantly related to non-obscene socially inappropriate symptoms and self-reported tic severity. Although experiencing socially inappropriate urges in general was correlated with the presence of mental coprolalia, only the presence of more severe tics was a good indicator of outbursts of obscene vocal tics. Having coprolalia was related to significantly poorer quality of life in TS. Conclusions: As outbursts of coprolalia exert a specific negative impact on quality of life clinicians should consider improvement in this symptom during evaluation of treatment efficacy.