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### Symptoms and comorbidity  Recent research has again demonstrated the wide prevalence of TS-associated comorbities and is a reminder of the need to do perform  studies with large enough sample sizes so that the effects of comorbities can be examined on the dependent variables of interest. A retrospective review of 1,000,000 people in the Taiwan National Health Insurance Research Database examined the association between epilepsy and TS \citep{26597416}. 1062 children and adolescents with TS were matched on age and sex with a control group of 3186. 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 clinicians follow TS children closely since they are at-risk for the development of epilepsy.   In a large study of psychiatric comorbidity in TS, approximately 800 families were recruited primarily from TS specialty clinics in four different countries over a 16-year period \citep{25671412}. A total of 1374 participants with TS and 1142 family members unaffected by TS were included. 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 genetic correlations between TS and mood were accounted for by ADHD and OCD, while ADHD alone accounted for the genetic correlations of TS with anxiety and disruptive behavior disorders. See also \citep*{Prime:Hirschtritt:2015}.  A study of 400 patients seen at a TS specialty clinic found that 39% had coprolalia and 20% had copropraxia \citep{26089672}. When the 222 patients with full comorbidity data were examined, only 13.5% had "pure" TS (i.e., without comorbidities). None of the "pure" TS group had coprolalia and none had a family history of obsessive-compulsive disorder. In contrast, 39% of the group with comorbidities exhibited coprolalia. These findings support previous findings that people with "pure" TS are substantially different from those who have comorbidities comorbid conditions  in addition to TS. Emotional regulation difficulties were described in three studies reminding us that TS patients often report that tics are the least of their problems. An experienced clinician, who has done research on "rage attacks" in TS, has provided a clinically useful summary of current knowledge regarding aggressive symptoms in TS, OCD, ADHD and mood disorders and described treatment options \citep{Budman_2015}. In another study, greater irritability was seen in TS adults with more severe tics and those with comorbid ADHD \citep{25716486}. \citep{26144583} found that both male and female TS subjects had significantly higher scores for personal distress and rated their abilities to take other people's perspectives lower than the control subjects did. Given that emotional regulation difficulties are frequently associated with greater tic severity, improving emotional modulation skills may also be an appropriate target of psychological interventions.