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## Phenomenology and natural history  Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome \citep{25671412} | This is In  an important, large study of psychiatric comorbidity in TS. See our F1000Prime Recommendation \citep*{Prime:Hirschtritt:2015}. | Approximately TS, approximately  800 families were recruited primarily from TS specialty clinics in four different countries over a 16 year period. 16-year period \citep{25671412}.  A total of 1374 participants with TS and 1142 family members unaffected by TS were included in the study. 86% of the TS participants had at least one psychiatric comorbidity and 72% had either OCD or ADHD. Other disorders, involving mood, anxiety or disruptive behavior, each occurred in approximately 30% of the TS participants.The participants. The  genetic correlations between TS and mood was accounted for by ADHD and OCD OCD,  while ADHD alone accounted for the genetic correlations between of  TS and with  anxiety and disruptive behavior disorders. _See also \citep*{Prime:Hirschtritt:2015}._  Total tic severity and vocal tic scores were significantly correlated with scores on the Premonitory Urge for Tics Scale and the University of Sao S\~ao  Paulo Sensory Phenomena Scale for TS adults (Kano "Sensory phenomena related to tics, obsessive-compulsive symptoms and global functioning"). \citep{Kano_2015}.  The PUTS scores and the USP-SPS scores were correlated with the scores on the Dimensional Yale-Brown Obsessive-Compulsive Scale. In addition, PUTS scores and USP-SPS total scores were both significantly correlated with tic complexity and YGTSS vocal tic scores. Influence of gender on Tourette syndrome beyond adolescence \citep{25193042} A follow-up study averaging 9 years of 75 TS patients, who had been patients previously  seen at a  University-based clinic, clinic  found that reported TS impairment was more likely to decrease over time  in males and increase in females. females \citep{25193042}.  In addition, women were more likely than men to have more body regions, primarily the upper extremities, affected by tics in adulthood. This result suggests that sex continues to influence TS symptoms beyond adolescence.  In an attempt Researchers used data from the Avon Longitudinal Study of Parents and Children  to determine whether there are identify  maternal psychological risk factors during pregnancy that increase the risk of tic disorders in offspring researchers used data from the Avon Longitudinal Study of Parents and Children (Ben-Shlmo et al., 2015). \citep{Ben_Shlomo_2015}.  The Avon Longitudinal Study is an ongoing, prospective, pre-birth cohort study of all children born in Avon, United Kingdom Kingdom,  between April 1, 1991 1991,  and Decmber December  31, 1992. Maternal questionnaires were administered throughout pregnancy and they completed questionnaires about themselves and their children's development every 6 months from the child's birth to age 7 and then every year thereafter. In the final multivariate model, chronic maternal anxiety, which was seen evident  both pre- before  and post-natally, after parturition,  was associated withthe occurrence of  TS and or  chronic tic disorders disorder  in their offspring. The authors suggest that this association may reflect shared genetic susceptiability susceptibility  or pre-natal prenatal  exposure. Baby videos provide a clue (Zappella et al., 2015) | 34 children in Italy were identified as having autistic behaviors in their second year of life. Families reported that development during the first year of life had been normal and they donated the videos that had been recorded before the age of 6 months. Videos of 18 boys were examined in detail. Abnormal general movements, which are spontaneously generated central pattern generators and modulated by more rostral brain regions, were seen 10 of the 11 boys who were eventually diagnosed with autism spectrum disorder between the ages of 3 and 7 years. In contrast, normal general movements were seen in the 8 boys who had autistic features. Interestinly, 7 of the 8 boys with transient autistic behaviors were later diagnosed with Tourette syndrome and 4 of the boys with autism spectrum disorder were diagnosed with TS as a comorbidity. These results, combined with the recent nearly ubiquitous availability of home baby videos in some cultures, suggest a pseudo-prospective study design to identify features predicting later development of TS.  Clinical features associated with an early onset in chronic tic disorders \citep{26596364} The clinical characteristics of children who developed TS before the age of 4 were compared with those who were older than 6. The younger group had a higher rate of stuttering, other speech disfluencies (e.g., speech initiation difficulties, speech prolongation), and oppositional defiant disorder. There was no difference between the two groups in rate of ADHD or obsessive-compulsive symptoms. Interestingly, the early-onset group was more likely to have a mother with tics. The authors suggested that this difference in onset age might be related to mother sensitivity to the child's symptoms resulting in tics being diagnosed at a younger age, possible prenatal or perinatal environmental factors or "maternally transmitted epigenetic modification or genomic imprinting which may be related to tic onset". onset." An alternative explanation may come from the fact that TS is much less common in girls than in boys, so tics in a woman may represent a higher genetic load. Just as a tall woman may have taller children than an equally tall man (all other things being equal), so children of a woman with tics may be more likely to have earlier onset than children of a man with tics.  A retrospective review of 1,000,000 people in the Taiwan National Health Insurance Research Database examined the association between epilepsy with TS> TS.  1062 children and adolescents with TS were identified. A group of 3186 without TS but matched on age and sex was used as a control group.The TS group had an 18-fold increased risk of epilepsy compared to the control group and even after adjusting for comorbidities (i.e., bipolar disorder, depression, learning difficulties, autism, anxiety disorder, sleep disorder), the risk of epilepsy was still 16-fold. Although the authors raise the issue that some tics may have been mistaken for seizures, they also suggest that TS children be followed closely for the development of epilepsy. A study of 400 patients seen at a TS specialty clinic found that 39% had coprolalia and 20% had copropraxia (Eapen & Robertson, 2015are there distinct subtypes). When the 222 patients with full comorbidity data were examined, only 13.5% had pure-TS. 39% of the group with comorbidities exhibited coprolalia compared to 0% of the pure-TS group. The pure-TS group had no family history of obsessive-compulsive disorder. In addition, individuals with complex tics were significantly more likely to report premonitory urges than individuals with simple tics.