Social communication deficits and restricted repetitive behavior symptoms in Tourette syndrome

Valsamma Eapen,1 Sarah McPherson,2 Lisa Karlov,1 Laura Nicholls,1 Rudi Črnčec,3 Aisling Mulligan4,51School of Psychiatry , University of New South Wales, Sydney, NSW, Australia; 2Medical Oncology, The Canberra Hospital, Canberra, ACT, Australia; 3Penrith Therapy Centre, Penrith, NSW, Australia; 4Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland; 5Dublin North City and County Child and Adolescent Mental Health Service, Health Services Executive, Dublin, IrelandBackground: Autism spectrum disorders (ASD) have been found to occur more frequently in individuals with Tourette syndrome (TS) than in the general population. Similarities exist between ASD and TS clinically, which suggests a potential relationship between the two conditions.Purpose: The purpose of this study was to explore the occurrence of autism-related features in ASD and TS, focusing on areas of overlap and difference.Patients and methods: This study examined the nature and extent of autistic traits as measured by the Social Communication Questionnaire (SCQ) in a sample with a diagnosis of TS, a sample diagnosed to have ASD, and a normative general population sample.Results: The TS sample had significantly higher mean SCQ scores than the general population, but generally lower scores than the ASD sample. The group differences in mean SCQ scores between the TS and ASD sample were significant except in the domain of restricted repetitive behaviours (RRB).Conclusion: This suggests that ASD traits occur commonly in the TS population, with a significant overlap in certain clinical features. This was especially the case for complex movements or repetitive behaviours, which may represent either: i) a shared phenotype which is subclinical, ii) a phenocopy where some clinical symptoms mimic each other, or iii) a co-morbidity. Awareness of this association can be useful in identifying these symptoms as part of the comprehensive assessment of TS and addressing these to improve the overall clinical outcomes in these patients.Keywords: Autism spectrum disorder, Tourette syndrome, clinical features, co-occurrence