July 7, 2026

@michaelokun

When Tourette syndrome is more than tics in adults: the hidden impact of depression and ADHD on quality of life. Tourette syndrome is a neurodevelopmental condition characterized by involuntary movements and sounds called tics. Psychiatric symptoms such as depression, anxiety and ADHD can travel alongside tics and may shape daily life as much as, or even more than, the tics themselves. Hartmann and colleagues describe in a new paper in Movement Disorders Clinical Practice how psychiatric symptoms influence tic severity and quality of life in 227 adults living w/ Tourette syndrome from Canada and France. Key points: - Depression emerged as the strongest factor associated w/ worse tic severity and tic related impairment. - Quality of life was influenced not only by tic severity, but also by depression, anxiety, ADHD and obsessive compulsive symptoms. - ADHD and depression had particularly strong effects on daily functioning and overall well-being, highlighting the importance of multidisciplinary care. My take: This paper reinforces something many of us who care for folks w/ Tourette syndrome see in the clinic every week. The tics are frequently the most visible part of the condition, however they may not be the biggest driver of suffering. Depression, anxiety and ADHD can quietly shape school performance, work success, relationships and self-esteem even in and especially in adults. We should be treating the whole person and not just counting tics. Here are 5 points that resonated w/ me: 1- Treating depression may improve more than mood and it may also positively influence tic severity and quality of life. 2- ADHD symptoms in adults w/ Tourette syndrome remain underrecognized and undertreated despite their major impact on daily function. 3- The severity of visible movements does not always match the degree of disability experienced by an individual. 4- Multidisciplinary care including neurology, psychiatry, psychology, behavioral therapy and social support is likely the best path forward. 5- The future of Tourette care should focus on the whole brain and the whole person rather than separating motor and psychiatric symptoms into different silos.