Other Problems

tosy.co.uk - Tourette Syndrome Support in the UK


 Article  "Tourette Syndrome, associated conditions and the complexities of treatment"


There is a lot of information available on the internet about the associated (and possible co-morbid) disorders of Tourette Syndrome, such as Obessessive-Compulsive Disorder (OCD), Attention Deficit Disorder (ADHD/ADD – which can occur with or without hyperactivity) and anger control problems.  Go to the Other Links page for further information on these, and more, associated, and possible co-morbid, disorders.


There are other issues, which haven’t been given so much attention, but are very relevant.


TS is tics, and those tics (and compulsions) often interfere with learning, as can some medication side-effects.


I have listed and given very brief details of other possible problems that may occur with Tourette Syndrome.


Learning Problems


TS has no effect on intelligence, but those with TS are more likely to have learning problems.  There may be delays or difficulties in learning one or more specific types of information.  Eg. Reading, handwriting, mathematics (may be better at mental arithmetic than written maths)


Auditory Processing Problems  Difficulty in taking in information by hearing eg. Following spoken instructions


Sensory Integration Problems  May affect any of the senses.  There may be over or under sensitivity eg. Over/under react to certain fabrics, clothes labels, more or less sensitive to pain, or over sensitivity to texture of certain food in the mouth, or aversion to certain smells.


Poor Visual-Motor Processing  Which may impair handwriting and other any other activity involving hand/eye co-ordination.


Poor Fine Motor Skills   (And perhaps gross motor skills)  There may be problems with handwriting, poor colouring and cutting skills.  Perhaps this also causes problems with dressing, such as handling small buttons, or tying shoe-laces.   Also using cutlery, and in art & craft activities.  The person may appear to be clumsy.     Dyspraxia


Difficulty in timed tests


Problems with memory and concentration




Developmental delays such as toilet training (especially night-time)


Poor organisational skills


Sleep problems


Mood swings




Emotional and social immaturity


School phobia – especially as side-effect of haloperidol


Low self-esteem


Behavioural issues including


Conduct Disorder or ODD (Oppositional Defiant Disorder)


Severe separation anxiety




Professor Mary Robertson wrote the article "Tourette Syndrome, associated conditions and the complexities of treatment" in 1999.   It was published in Brain (2000), 123, 425-462  (Oxford University Press)


Extract of article  Includes introduction only (subscription necessary for full text)


Excerpt from 'Conclusions'


To summarise, and in the author's opinion (taking into account the literature and personal experience), there is no doubt that ADHD is very common in TS, even in mild cases.  It is thought that, in time, it will be clear that there is a specific type of ADHD which is peculiar to TS, which is phenomenologically different from that in pure ADHD, but it is unclear as to whether or not this has treatment implications. 

There is no doubt at all, as evidenced by the literature, that OCS/OCB are integral to TS; they are common in TS and genetically related, but are different from pure OCD and this does have treatment implications (neuroleptics are used in addition to SSRIs).  SIB is also common in TS, and in the author's opinion may well  prove to be integral to TS; it can occur in mild TS individuals, is related to OCS/OCB and is often difficult to treat.  In the author's opinion, the depression in TS is highly likely to be multifactoral in aetiology, highlighting the importance of a full psychiatric history and mental state examination in each patient.  The anxiety, personality disorders and other behavioural problems are often seen in TS clinics and may be due either to the comorbity of ADHD or to referral bias.



Abbreviations used   -  OCS (obsessive compulsive symptoms), OCB (obsessive compulsive behaviours), OCD (OC disorder), SIB (self-injurious behaviours), ADHD (attention deficit hyperactivity disorder), SSRIs (selective serotonin reuptake inhibitors)


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 17 March 2002  Date last updated