Systematic Literature Review on Public Health Impacts of Tourette Syndrome and Persistent Tic Disorders: General Health, Health Conditions, and Health Behaviors.

BACKGROUND

The association of tic disorders and physical health has not been comprehensively described. This systematic review summarized the associations between indicators of physical health (e.g., health-related quality of life [HR-QoL]), health conditions, and health behaviors with Tourette syndrome (TS) and persistent tic disorders (PTD) in individuals across the lifespan.

METHODS

We used multiple databases to search the literature through March 5, 2025, and identified 84 studies published in English in 2003 or later that reported health-related outcomes among individuals with TS/PTD and a comparison group without TS/PTD. In describing differences between groups, we considered statistical significance and the magnitude of the difference, particularly when statistical comparisons were not reported. Risk of bias was conducted using the Newcastle-Ottawa Scale.

RESULTS

Several indicators of poor health and several health conditions were more prevalent among individuals with TS/PTD, compared with those without, including some measures of lower HR-QoL, overall poor health/disability, mortality, injuries, suicidal thoughts and behaviors, orthopedic conditions, neurological disorders, sleep disorders, endocrine conditions, immune-related disorders including asthma and allergy, and hearing and/or vision problems. Findings across studies were inconsistent for gastrointestinal and circulatory system conditions, and infection and fever. Findings did not differ by TS/PTD status for body mass index and health behaviors. Strengths and limitations of this body of literature are discussed.

CONCLUSIONS

Findings from this review can be used to inform health care provider education activities and future research to improve the health and well-being of individuals with TS/PTD.