Tourette syndrome and chronic tic disorder are associated with lower socio‐economic status: findings from the Avon Longitudinal Study of Parents and Children cohort

• Published in: Developmental medicine and child neurology 2014-02, Vol.56 (2), p.157-163
• Main Authors: Miller, Laura L, Scharf, Jeremiah M, Mathews, Carol A, Ben‐Shlomo, Yoav
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Cohort Studies; Cross-Sectional Studies; Educational Status; Female; Housing; Humans; Longitudinal Studies; Male; Neurologic Examination; Odds Ratio; Original; Psychosocial Deprivation; Risk Factors; Socioeconomic Factors; Statistics as Topic; Tourette Syndrome - epidemiology; United Kingdom
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.12318

Aim Only a few studies have examined the relationship between Tourette syndrome or chronic tic disorder and socio‐economic status (SES). Existing studies are primarily cross‐sectional, arise from specialty clinics, and use single measures of SES. In this study we examine this relationship in a longitudinal, population‐based sample. Method Data are from 7152 children born during 1991 and 1992 in the county of Avon, UK, from the Avon Longitudinal Study of Parents and Children, who were followed up to age 13. After exclusions for intellectual disability* and autism, 6768 participants (3351 males [49.5%]) and 3417 females [50.5%]) remained. Parental SES was assessed using multiple measures during pregnancy and at 33 months of age. Presence of Tourette syndrome or chronic tics was determined from repeated maternal questionnaires up to when the child was 13 years of age. Results Multiple SES measures were associated with an approximately twofold increased risk of Tourette syndrome and chronic tics. A postnatal composite factor score (lowest vs highest tertile odds ratio 2.09, 95% confidence interval 1.38–3.47) provided the best fit to the data. Interpretations As is seen in several childhood conditions, such as cerebral palsy and autism, lower SES is a risk factor for Tourette syndrome/chronic tics. Potential explanations include differential exposure to environmental risk factors or parental psychopathology as a measure of an increased genetic risk leading to decreased parental SES. What this paper adds Lower SES is associated with a twofold greater risk of Tourette syndrome/chronic tics. This association was examined using a large prospective birth cohort (ALSPAC) and a multidimensional composite measure. Single or area‐based measures may be inadequate. Genetic factors or social patterning of an adverse environmental aetiological factor may explain this observation.