University of California, San Francisco.
Johns Hopkins University School of Medicine, Baltimore.
J Am Acad Child Adolesc Psychiatry. 2017 Jul;56(7):610-617.e1. doi: 10.1016/j.jaac.2017.05.002. Epub 2017 May 11.
Tourette's disorder (TD) and autism spectrum disorder (ASD) share clinical features and possibly an overlapping etiology. The aims of this study were to examine ASD symptom rates in participants with TD, and to characterize the relationships between ASD symptom patterns and TD, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD).
Participants with TD (n = 535) and their family members (n =234) recruited for genetic studies reported TD, OCD, and ADHD symptoms and completed the Social Responsiveness Scale Second Edition (SRS), which was used to characterize ASD symptoms.
SRS scores in participants with TD were similar to those observed in other clinical samples but lower than in ASD samples (mean SRS total raw score = 51; SD = 32.4). More children with TD met cut-off criteria for ASD (22.8%) than adults with TD (8.7%). The elevated rate in children was primarily due to high scores on the SRS Repetitive and Restricted Behaviors (RRB) subscale. Total SRS scores were correlated with TD (r = 0.27), OCD (r = 0.37), and ADHD (r = 0.44) and were higher among individuals with OCD symptom-based phenotypes than for those with tics alone.
Higher observed rates of ASD among children affected by TD may in part be due to difficulty in discriminating complex tics and OCD symptoms from ASD symptoms. Careful examination of ASD-specific symptom patterns (social communication vs. repetitive behaviors) is essential. Independent of ASD, the SRS may be a useful tool for identifying patients with TD with impairments in social communication that potentially place them at risk for bullying and other negative sequelae.
妥瑞氏症（TD）和自闭症谱系障碍（ASD）具有共同的临床特征，并且可能具有重叠的病因。本研究的目的是检查患有 TD 的参与者的 ASD 症状发生率，并描述 ASD 症状模式与 TD、强迫症（OCD）和注意力缺陷/多动障碍（ADHD）之间的关系。
参加者有 TD（n=535）及其家庭成员（n=234）招募进行基因研究报告 TD、强迫症和多动症的症状，并完成社会反应量表第二版（SRS），用于描述 ASD 症状。
参与者的 SRS 分数与其他临床样本观察到的分数相似，但低于 ASD 样本（平均 SRS 总原始分数= 51；SD= 32.4）。患有 TD 的儿童符合 ASD 标准的比例（22.8%）高于患有 TD 的成年人（8.7%）。儿童中这一比例的升高主要是由于 SRS 重复和受限行为（RRB）子量表的高分。总 SRS 分数与 TD（r=0.27）、强迫症（r=0.37）和多动症（r=0.44）相关，并且在 OCD 症状表型的个体中比单纯 Tic 的个体更高。
在受 TD 影响的儿童中观察到的 ASD 更高发生率可能部分是由于难以区分复杂的抽动和 OCD 症状与 ASD 症状。仔细检查 ASD 特定的症状模式（社交沟通与重复行为）是必不可少的。无论是否存在 ASD，SRS 可能都是一种有用的工具，可用于识别患有 TD 的患者，他们在社交沟通方面存在障碍，可能面临欺凌和其他负面后果的风险。
