
Am J Psychiatry 163:1066-1073, June 2006
doi: 10.1176/appi.ajp.163.6.1066
© 2006 American Psychiatric Association
Association Between Maternal Smoking and Increased Symptom Severity in Tourettes Syndrome
Carol A. Mathews, M.D.,
Brianne Bimson, B.S.,
Thomas L. Lowe, M.D.,
Luis Diego Herrera, M.D.,
Cathy L. Budman, M.D.,
Gerald Erenberg, M.D.,
Allen Naarden, M.D.,
Ruth D. Bruun, M.D.,
Nelson B. Freimer, M.D., and
Victor I. Reus, M.D.
OBJECTIVE: Substantial evidence suggests that both environmental and genetic factors contribute to the development and clinical expression of Tourettes syndrome. Although genetic studies of Tourettes syndrome are common, studies of environmental factors are relatively few and have not identified consistent risk factors across studies. This study examines in a large cohort of subjects (N=180) the relationship between prenatal/perinatal adverse events with Tourettes syndrome severity as determined by tic severity and rates of commonly comorbid disorders such as obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and self-injurious behavior. METHOD: Tic severity, OCD, ADHD, self-injurious behavior, and exposure to a variety of prenatal/perinatal events were systematically assessed in all subjects enrolled in three genetic studies of Tourettes syndrome. Using linear and logistic regression, a best-fit model was determined for each outcome of interest. RESULTS: Prenatal maternal smoking was strongly correlated with increased tic severity and with the presence of comorbid OCD in these Tourettes syndrome subjects. Other variables, such as paternal age and subjects birth weight, were significantly but less strongly associated with increased symptom severity. The authors found no association between symptom severity and hypoxia, forceps delivery, or hyperemesis during pregnancy, which have been previously identified as risk factors. CONCLUSIONS: This study identifies prenatal maternal smoking as a strong risk factor for increased symptom severity in Tourettes syndrome.
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Prenatal Environmental Contributions to Severity in Tourette Syndrome
Journal Watch Psychiatry,
July 11, 2006;
2006(711):
5 - 5.
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