Self- and proxy-reported measures of behavioural symptoms in young patients with Tourette syndrome: A controlled study

Aims Tourette syndrome (TS) is a neurodevelopmental disorder characterised by multiple tics and associated with co-morbid behavioural problems (TS-plus). We investigated the usefulness of self-report vs parent- and teacher-report instruments in assisting the specialist assessment of TS-plus in a child/adolescent population. Methods Twenty-three patients diagnosed with TS (19 males; age 13.9±3.7 years) and 69 matched healthy controls participated in this study. All recruited participants completed a standardised psychometric battery, including the Children's Depression Inventory (CDI), the Self Administrated Psychiatric Scales for Children and Adolescents (SAFA) and the State–Trait Anger Expression Inventory (STAXI). Parents completed the Child Behavior Checklist (CBCL) and Conners' Parent Rating Scales–Revised (CPRS-R). Participants' teachers completed the Conners' Teacher Rating Scales–Revised (CTRS-R). Results were compared with similar data obtained from controls. Results Nineteen patients (82.6%) fulfilled DSM-IV-TR criteria for at least one co-morbid condition: obsessive-compulsive disorder (OCD, n=8; 34.8%); attention deficit-hyperactivity disorder (ADHD, n=6; 26.1%); OCD+ADHD (n=5; 21.7%). Scores on self-report instruments failed to show any significant differences between TS and controls. Most subscores of the CPRS-R, CTRS-R, and CBCL were significantly higher for the TS group than controls. The TS+OCD subgroup scored significantly higher than the TS-OCD subgroup on the CBCL-Externalising, Anxious/Depressed and Obsessive-Compulsive subscales. Conclusions Self-report instruments appear to have limited usefulness in assisting the assessment of the behavioural spectrum of young patients with TS. However, proxy-rated instruments differentiate TS populations from healthy subjects, and the CBCL can add relevant information to the clinical diagnosis of co-morbid OCD.