While most people with Tourette syndrome (TS) or chronic tic disorder (CTD) do not experience violent assault or criminal convictions, people diagnosed with TS or CTD in specialist settings have a higher likelihood of experiencing violent assault as well as perpetrating violence compared with people from the general population. Researchers published their findings in JAMA Neurology. 

“The cumulative incidence [of experiencing any violent assault] was 14% in those followed up from birth, compared with 5% in the general population; patient and control groups started to diverge already before age 15 years, indicating early vulnerability to experiencing violent assault,” researchers reported.

The study compared risks for violent assault and criminal convictions in 7791 people with TS or CTD diagnosed in specialist settings and 13.8 million unaffected people in Sweden.

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People with TS or CTD had a 2-fold increased risk of experiencing sexual or nonsexual violent assault, a 3-fold increased risk of violent crime convictions, and a 1.6-fold increased risk of nonviolent crime convictions compared with the general population, according to the study. Adjusted hazard ratios were 2.21 for experiencing any violent assault, 3.13 for violent crime convictions, and 1.62 for nonviolent crime convictions.

Some 37% of people with TS or CTD who had experienced violent assault also had a violent crime conviction, the study found, compared with 17.9% of the general population.

Risks were highest in people with comorbid attention-deficit/hyperactivity disorder and substance use disorders, they study suggested.

“From a clinical perspective, early detection and management of TS and CTD and associated comorbidities are key. It is paramount to improve access to specialist multidisciplinary teams and to evidence-based treatments, particularly behavior therapy, for TS and CTD,” researchers wrote. “From a social perspective, more needs to be done to support patient organizations in their efforts to educate the general public about TS and CTD and to reduce the considerable stigma and misunderstanding still associated with these disorders.”

Reference

Mataix-Cols D, Virtanen S, Sidorchuk A, et al. Association of Tourette syndrome and chronic tic disorder with violent assault and criminal convictions. JAMA Neurol. Published online March 21, 2022. doi: 10.1001/jamaneurol.2022.0167