Gilles de la Tourette Syndrome. The Relationship of Anxiety, Depression and OCD with Quality of Life and Tic Severity in GTS
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Anxiety disorders and depression are common co-morbidities in people with the Gilles de la Tourette syndrome (GTS), yet little research has been done concerning this relationship. This study aims at exploring anxiety (disorders and symptoms), OCD (disorder and symptoms), depressive symptoms, related to tic severity and health related quality of life (HrQoL) in a large sample. The expectations were: anxious, depressive symptoms, and OCD correlate with tic severity and HrQoL; patients with pure GTS experience higher anxiety, depressive symptoms, tic severity and lower HrQoL than a control group; GTS patients with co-morbid OCD (GTS+OCD), and GTS patients with co-morbid non-OCD anxiety disorders (GTS+AD) score higher on anxiety, depressive symptoms, tic severity and lower on HrQoL than pure GTS patients and a control group. In total 187 participants with a DSM-IV-TR Gilles de la Tourette syndrome (GTS) diagnosis and 185 unaffected family members took part in the study. Participants were assessed on mental disorders using the MINI and the SCID (standardized interviews); or OCB using the Y-BOCS; on tic severity using the YGTSS; on depression and anxiety using BDI and BAI, and on health related quality of life using the EQ VAS. The results showed that tic severity was correlated and predicted by OCB, but not by anxiety or depressive symptoms. Further, HrQoL was correlated with anxiety, depressive symptoms and with OCB, and was predicted by depressive symptoms, but was not associated with tic severity. Between-group comparisons (pure GTS, GTS+OCD, GTS+AD) revealed that higher levels of anxiety and depressive symptoms in GTS were related to the presence of co-morbid OCD. In conclusion, the presence of co-morbidity leads to lower HrQoL, whereas tic severity does not lower QOL. This notion has several treatment implications.