Impact of obsessive-compulsive symptoms in Tourette's syndrome on neuropsychological performance.

AIM: Although inconsistencies in neuropsychological impairments in Tourette's syndrome (TS) have been discussed with respect to comorbid disorders, such as obsessive-compulsive disorder, few studies have focused on the specific dimensions of obsessive-compulsive symptoms (OCS) related to TS, such as aggression and symmetry. The aim of this study was to explore the impact of specific TS-related OCS on neuropsychological performance. METHODS: A series of neuropsychological tasks examining attention and executive functioning were performed in groups of 33 TS participants and 18 healthy controls. The neuropsychological performance of TS with Aggression OCS (n = 11) were compared to TS without Aggression OCS (n = 22) and controls by using MANCOVA controlling for age. In the same way as Aggression, we compared the performance of three groups by Symmetry: TS with Symmetry OCS (n = 14), TS without Symmetry OCS (n = 19) and controls. RESULTS: TS participants with Aggression OCS tended to make more perseverative errors than those without. Global OCS severity and tic severity did not correlate with any neuropsychological performances. No significant differences were detected between TS participants with and without Symmetry OCS. CONCLUSION: Neuropsychological deficits in TS might be affected not by global OCS severity but by specific TS-related OCS.

Obsessive-compulsive symptom dimensions in Japanese tourette syndrome subjects.

OBJECTIVES: To investigate the current and lifetime frequency and severity of obsessive-compulsive (OC) symptom dimensions in Tourette syndrome (TS) patients, and how these dimensions affect clinical characteristics. METHODS: Forty TS outpatients (29 males, 11 females) were interviewed with the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), the Yale Global Tic Severity Scale (YGTSS), the Shapiro Tourette Syndrome Severity Scale, and the Global Assessment of Functioning (GAF). RESULTS: OC symptoms were present in 80% of the total sample. The miscellaneous and the symmetry dimensions were the most frequent at the "current" and "lifetime" surveys, respectively. The aggression dimension had the smallest difference between "worst ever" and current ratings among the all OC symptom dimensions. TS patients with the aggression dimension (n=7) had significantly lower scores in the GAF scale and higher frequencies of coprolalia. There were significant correlations between the YGTSS severity scores and specific DY-BOCS dimensions. CONCLUSION: OC symptoms are frequent in TS subjects and there were differences in the frequency, severity, and course of the OC symptom dimensions. These results emphasize the need for future longitudinal studies using a dimensional approach for the evaluation of OC symptoms in tic disorders.

Relationship of intentional self-harm using sharp objects with depressive and dissociative tendencies in pre-adolescence-adolescence.

AIMS: The objectives of the present study were to (i) evaluate the prevalence of children and adolescents who have engaged in intentional self-harm using a sharp object; and (ii) investigate the relationship between self-harm with sharp objects and depressive tendencies or dissociative tendencies. METHODS: A total of 1938 students in grades 5-12 in Yokohama, Japan, were enrolled, and they completed anonymous self-report questionnaires including a question about intentional self-harm with a sharp object, the Depression Self-Rating Scale for Children (DSRSC) and the Adolescent Dissociative Experiences Scale (A-DES). RESULTS: The prevalence of self-harm using sharp object was 5.4% among male 5th-6th graders, 4.0% among female 5th-6th graders, 5.3% among male 7th-9th graders, 15.1% among female 7th-9th graders, 6.6% among male 10th-12th graders, and 9.6% among female 10th-12th graders. Categorical regression analysis showed that a small amount of variance in self-harm by sharp object was explained by DSRSC and A-DES scores. CONCLUSIONS: Self-harm with a sharp object was prevalent among pre-adolescents and adolescents and was associated with depressive and dissociative tendencies.

The impact of tics, obsessive-compulsive symptoms, and impulsivity on global functioning in Tourette syndrome.

This study investigated the relationships between tics, obsessive-compulsive symptoms (OCS), and impulsivity, and their effects on global functioning in Japanese patients with Tourette syndrome (TS), using the dimensional approach for OCS. Fifty-three TS patients were assessed using the Yale Global Tic Severity Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Impulsivity Rating Scale, and the Global Assessment of Functioning Scale. Although tic severity scores were significantly and positively correlated with OCS severity scores, impulsivity severity scores were not significantly correlated with either. The global functioning score was significantly and negatively correlated with tic and OCS severity scores. Of the 6 dimensional OCS scores, only aggression scores had a significant negative correlation with global functioning scores. A stepwise multiple regression analysis showed that only OCS severity scores were significantly associated with global functioning scores. Despite a moderate correlation between tic severity and OCS severity, the impact of OCS on global functioning was greater than that of tics. Of the OCS dimensions, only aggression had a significant impact on global functioning. Our findings suggest that it is important to examine OCS using a dimensional approach when analyzing global functioning in TS patients.