Prevalence and comorbidity of tic disorder in Israeli adolescents: results from a national mental health survey.

BACKGROUND: Tic disorders are common causes of morbidity in Israel but their prevalence in this country needs further study. OBJECTIVES: To assess the prevalence of mental disorders in Israeli youth including tic disorders, as part of the Israel Survey of Mental Health among Adolescents (ISMEHA). METHODS: The ISMEHA was conducted in a representative sample of 957 adolescents aged 14-17 and their mothers during 2004-2005. We interviewed the adolescents and their mothers in their homes and collected demographic information about the use of services. We also administered a psychiatric interview, the Development and Well-Being Assessment inventory (DAWBA), which included a question on tic disorder. The prevalence of tic disorders was calculated based on the adolescents' and maternal reports. The relationships among demographic data, comorbidity rates, help-seeking behaviors and tic disorder are presented. RESULTS: The prevalence of tics was 1.3% according to maternal reports and 4.4% according to adolescents' reports. The prevalence correlated with externalizing disorders and learning disabilities. A higher prevalence of tics was found in the Arab population compared with Jewish adolescents. CONCLUSIONS: The prevalence of tic disorders in Israel, as measured by a direct question in this epidemiological study, and associated comorbidities concurs with previous reports. The complexities of prevalence estimations, comorbidities, demographic correlates, and help-seeking behaviors are discussed.

Latah in Jakarta, Indonesia.

OBJECTIVE: To investigate the characteristics of latah in modern Indonesia; to determine whether contemporary latah resembles the syndrome described in the nineteenth century; to compare the syndrome of latah to other disorders featuring tics or exaggerated startle responses. BACKGROUND: Latah, described centuries ago in Malay people, is characterized by an exaggerated motor startle response, often with associated involuntary vocalizations, echolalia, echopraxia, and forced obedience. Modern latah has not been systematically studied. DESIGN AND METHODS: Persons with latah living in Jakarta, Indonesia, were investigated using a standardized, videotaped protocol. RESULTS: Fifteen women were studied. All had exaggerated startle to touch, and 10 to frightening words. Echolalia was seen in 10, echopraxia in 11, and forced obedience in 13. The startle response did not habituate, but instead worsened in response to repeated stimuli. Startle and associated symptoms were only partially suppressible in fewer than half. CONCLUSION: Modern latah resembles that described over a century ago. Latah resembles other disorders with exaggerated startle response, but is clinically distinct from Tourette's Syndrome.