Similarly, adults with pure TS do not appear to have the social difficulties present in those with TS plus ADHD.Among those with an older age of onset, more substance abuse and mood disorders are found, and there may be self-injurious tics. Adults who have severe, often treatment-resistant tics are more likely to also have mood disorders and OCD. Coprolalia is more likely in people with severe tics plus multiple comorbid conditions. Neuropsychological function
There are no major impairments in neuropsychological function among people with Tourettes, but conditions that occur along with tics can cause variation in neurocognitive function. A better understanding of comorbid conditions is needed to untangle any neuropsychological differences between TS-only individuals and those with comorbid conditions.Only slight impairments are found in intellectual ability, attentional ability, and nonverbal memory—but ADHD, other comorbid disorders, or tic severity could account for these differences. In contrast with earlier findings, visual motor integration and visuoconstructive skills are not found to be impaired, while comorbid conditions may have a small effect on motor skills. Comorbid conditions and severity of tics may account for variable results in verbal fluency, which can be slightly impaired. There might be slight impairment in social cognition, but not in the ability to plan or make decisions. Children with TS-only do not show cognitive deficits.
In teenagers and adults with an abrupt onset of tics and other behavioral symptoms, a urine drug screen for stimulants might be requested.Increasing episodes of tic-like behavior among teenagers (predominantly adolescent girls) were reported in several countries during the COVID-19 pandemic. Researchers linked their occurrence to followers of certain TikTok or YouTube artists. Described in 2006 as psychogenic, abrupt-onset movements resembling tics are referred to as a functional movement disorder or functional tic-like movements. Functional tic-like movements can be difficult to distinguish from tics that have an organic (rather than psychological) cause. They may occur alone or co-exist in individuals with tic disorders. These tics are inconsistent with the classic tics of TS in several ways: the premonitory urge (present in 90% of those with tics disorders) is absent in functional tic-like movements; the suppressibility seen in tic disorders is lacking; there is no family or childhood history of tics and there is a female predominance in functional tics, with a later-than-typical age of first presentation; onset is more abrupt than typical with movements that are more suggestible; and there is less co-occurring OCD or ADHD and more co-occurring disorders.