OBJECTIVE: Several studies report a greater than expected concurrence for Tourette’s syndrome (TS) with autistic disorder (AD). TS and bipolar disorder (BD) also may co-occur at a greater than expected rate. The authors assess whether there is a greater than expected concurrence for TS+AD+BD. METHOD: Four patients who had at some time in their lives diagnoses of TS, AD, and BD were identified. Three of these had concurrent TS+AD+BD. Diagnoses were made according to DSM-III-R criteria. Each of these patients was living in North Dakota and was in the authors’ care at the time of this study. RESULTS: The point prevalence (risk) for concurrent TS+AD+BD in North Dakota is not less than 4.6 x10(-6). The developmental sequence of syndromes in these four patients was AD, then TS and then BD. Data from the authors’ previously published, population-based prevalence studies indicate that TS+AD+BD co-occur at a greater than chance expectation. CONCLUSIONS: Common etiological factors may be involved in the greater than chance concurrence of TS+AD+BD. (Kerbeshian, J. & Burd, L. (1996). Case study: Comorbidity among Tourette’s syndrome, autistic disorder, and bipolar disorder. Journal of the American Academy of Child Adolescent Psychiatry, 35(5), 681-5)
A question that often crosses my mind is if autism and Tourette’s are both conditions with evolution origins, is Tourette’s a precursor to autism? Or, do they represent two different forebear evolutionary branches.
A not uncommon feature of Tourette’s is obsessive compulsive disorder. A man with Tourette’s I know compulsively self grooms, picking at tiny flecks upon his person. When a woman walks into a room he often emotes unique noises. This man is also brilliant and uncommonly strong.
This particular person was displaying possible features of a human progenitor. If autism and Tourette’s are related, as this study suggests, what features of autism might suggest precursor?
