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Tourette Syndrome–Associated Psychopathology: Roles of Comorbid Attention-Deficit Hyperactivity Disorder and Obsessive-Compulsive Disorder

Pollak, Yehuda PhD; Benarroch, Fortu MD; Kanengisser, Liana MA; Shilon, Yuval MD; Benpazi, Hilla MD; Shalev, Ruth S. MD; Gross-Tsur, Varda MD


In the article that appeared on page 413 of volume 30, issue 5 of the Journal of Developmental & Behavioral Pediatrics , the author's name should have been listed as Hilla Ben-Pazi.

1. Pollak Y, Benarroch F, Kanengisser L, et al. Tourette syndrome-associated psychopathology: Roles of comorbid attention-deficit hyperactivity disorder and obsessive-compulsive disorder. J Dev Behav Pediatr . 2009;30:413–419.

Journal of Developmental & Behavioral Pediatrics. 32(9):691, November-December 2011.

Journal of Developmental & Behavioral Pediatrics: October 2009 - Volume 30 - Issue 5 - p 413-419
doi: 10.1097/DBP.0b013e3181ba0f89
Original Article

Objective: Individuals with Tourette syndrome (TS) often display comorbid symptoms of attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD), as well as externalizing and internalizing behaviors. This study was aimed to examine the impacts of tic severity, ADHD symptoms, and OCD on internalizing (e.g., anxiety) and externalizing (e.g., aggression) psychopathology.

Methods: Using linear regressions, we examined how tics, ADHD, and OCD symptoms predicted the externalization and internalization behaviors measured by the Child Behavior Checklist in a clinical sample of children and adolescents with TS. In addition, Child Behavior Checklist scales were compared among children with TS without ADHD, TS and ADHD, ADHD without TS, and unaffected control group.

Results: In the TS group, externalizing behaviors were predicted by tic severity, inattention, and hyperactivity/impulsivity but not by OCD symptoms, whereas internalizing behaviors were predicted by inattention and OCD symptoms but not by tic severity or hyperactivity/impulsivity. Comparison among different clinical groups revealed main effects of TS and ADHD on both externalizing and internalizing behaviors.

Conclusion: These findings suggest that tics, ADHD, and OCD symptoms differentially explain the variance in externalizing and internalizing behavioral problems in individuals with TS. In addition, the data support the notion that TS is itself a risk factor for behavioral problems, mandating that children with TS even without ADHD and OCD still need to be assessed and treated for psychopathology.

From the Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel.

Received November 2008; accepted July 2009.

Address for reprints: Yehuda Pollak, PhD, Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.