Psychiatric co-morbidity is common in Tourette syndrome (TS) and is associated with increased tic severity, distress and impairment. However, few comprehensive assessments of TS co-morbidities exist, and little is known about differences in co-morbidities between children and adults. Clarification of rates and predictors of TS co-morbidities across the lifespan would provide insight into the developmental course of TS and possibly its underlying pathophysiology. Most previous studies examining co-morbidities in children and adolescents are limited by small sample sizes or lack of formal assessment with standardized diagnostic instruments. The few available studies on adult co-morbidities are also small and often relied on clinician report or chart review to generate co-morbid diagnoses. For these reasons, it is important to investigate how TS co-morbidities differentially emerge in development from childhood to adulthood. The Tourette Syndrome Association International Consortium for Genetics (TSAICG) has collected a rich set of phenotypic data and DNA samples from 916 individuals with TS. All subjects were interviewed using clinician interviews, the TSAICG diagnostic instrument for tics, OCD and ADHD, and a complete SCID (adult) or KSADS (child/adolescent) to generate lifetime diagnoses of TS and DSM-III-R/IV-TR psychiatric co-morbidities. Diagnoses were confirmed using a best-estimate approach, where two clinical experts reviewed all primary data to make independent diagnostic ratings. The goals of this study are to: 1) Examine differences in prevalence rates and patterns of psychiatric co-morbidities between children, adolescents, and adults with TS. 2) Evaluate predictors of psychiatric co-morbidity in children, adolescents and adults including age, gender, age of onset, tic severity, referral source, and personal and/or family history of co-morbidities. 3) Investigate predictors of tic persistence into adulthood including co-occurring psychiatric conditions. Paul Christopher Lee, M.D., Brigham and Women’s Hospital, Boston, MA Jeremiah M. Scharf, M.D., Ph.D., Massachusetts General Hospital, Boston, MA Carol Mathews, M.D., University of California, San Francisco, CA Award: $40,000 (Fellowship) Commentary: Individuals with Tourette syndrome (TS) often have additional psychiatric conditions that may cause more problems than their tics. With detailed information obtained from an extremely large group of people with TS collected by the Tourette Syndrome Association International Consortium for Genetics (TSAICG), the author has the opportunity to examine how often and when these psychiatric conditions arise in children, adolescents and adults with TS. He also plans to look at which factors might predict the development of associated conditions at different life stages and which factors might predict the persistence of tics into adulthood. Tourette Association of America Inc. – Research Grant Award 2011-2012