Santangelo S L, Pauls D L, Goldstein J M, Faraone S V, Tsuang M T, Leckman J F
Department of Epidemiology, Harvard Program in Psychiatric Epidemiology and Biostatistics, Harvard School of Public Health, Boston, MA.
J Am Acad Child Adolesc Psychiatry. 1994 Jul-Aug;33(6):795-804. doi: 10.1097/00004583-199407000-00004.
To explore the influence of gender and comorbid obsessive-compulsive disorder (OCD) on the phenomenology of Tourette's syndrome (TS).
TS proband groups defined by gender and comorbid OCD status were compared on a variety of sociodemographic variables, clinical characteristics, and perinatal complications.
Compared to females, males more often onset with rage and had ever experienced any form of simple tics. Females onset with compulsive tics more often than males. Probands with comorbid OCD were more likely than those without OCD to onset with complex tics. Delivery complications, especially forceps deliveries, were associated with being male and with having OCD. Fetal exposure to relatively high levels of coffee, cigarettes, or alcohol predicted OCD in TS probands. Diagnosis of TS occurred at later ages among females than among males. Males and females displayed different age distributions.
Males and females tend to experience different kinds of symptoms at onset. However, the overall experience of TS appears to be similar for both groups. Perinatal brain injury is implicated in the etiology of TS in some boys. Early brain injury may cause or exacerbate the development of OCD in some TS sufferers.
探讨性别及共病强迫症（OCD）对抽动秽语综合征（TS）现象学的影响。
比较按性别和共病OCD状态定义的TS先证者组在各种社会人口统计学变量、临床特征和围产期并发症方面的情况。
与女性相比，男性更常以愤怒起病，且曾经历过任何形式的简单抽动。女性比男性更常以强迫性抽动起病。共病OCD的先证者比无OCD的先证者更易以复杂性抽动起病。分娩并发症，尤其是产钳分娩，与男性及患OCD有关。胎儿接触相对高水平的咖啡、香烟或酒精可预测TS先证者患OCD。TS的诊断在女性中比在男性中出现得更晚。男性和女性表现出不同的年龄分布。
男性和女性在起病时往往经历不同类型的症状。然而，两组TS的总体经历似乎相似。围产期脑损伤在一些男孩TS的病因中起作用。早期脑损伤可能在一些TS患者中导致或加重OCD的发展。
