Clinical Rating Instruments in Tourette Syndrome

The complex motor and behavioral phenotype of Tourette syndrome presents a unique challenge to measurement and clinical observations. This chapter offers a systematic overview of the different clinician-, informant-, and self-report rating instruments for tics and associated phenomena that are available for use in clinical practice and/or research settings. Each of the scales available to measure tics has strengths and limitations; among the latter, the difficulty of capturing all the different dimensions of tic symptoms, such as frequency, intensity, interference, and impairment, is one of the most common and is an object of future research. Moreover, the visible and audible nature of core Tourette syndrome symptoms allows direct observation of these symptoms using specific video protocols. A wide range of psychometrically validated clinician- and self-rated measures for obsessive-compulsive behavior, attention-deficit/hyperactivity disorder, and depressive and anxiety symptoms are also available for use in clinical practice and/or research settings. The use of behavioral measures with adequate psychometric indices is recommended. Clinicians and researchers ideally should combine information from professionals and patients (as well as informants if possible) to ensure that the information gathered is comprehensive and accurate.