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We retrospectively studied 101 children with Tourettes's syndrome to characterize the early course of illness and associated behavioral disturbances of attention deficit hyperactivity disorder(ADHD),obsessive- compulsive disorder(OCD),disruptive behavior(DB),and school problems(SP). For patients without ADHD(45%),OCD(50%),DB(67%),or SP(52%)at the time of initial evaluation,13%developed ADHD,8%OCD,28%DB,and 25%SP during the observation period of 1.6+/-1.3 years(range,0.5 to 7 years).For patients with behavioral disturbances initially,the problems were controlled or resolved for many over time and with therapy:ADHD,46%;OCD,47%;DB,50%;and SP,67%.Medication changes,assessed after a drug adjustment period between the initial and first follow-up visits(6+/-6 months),showed that drug dosages remained largely unchanged and few patients required the addition of new drugs;tic suppressants,10%;anti-obsessional agents,5%;and stimulants,12%.Tic suppressants were withdrawn from 12%. |
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