European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part I: assessment
ESSTS · 2021 · Europe
Source and licence
- Authors
- Natalia Szejko, Sally Robinson, Andreas Hartmann et al.
- Title
- European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part I: assessment
- Journal
- European Child & Adolescent Psychiatry, 2021
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC8521086
Licence statement of the original publication
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This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
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Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
Physical examination
- We recommend physical and particularly neurological examination, when clinically indicated to exclude other neurological diseases in addition to tics. Neuroimaging, EEG and further additional examinations do not add value in establishing the diagnosis of a tic disorder and therefore, should be performed only if clinically indicated. For further information please refer to the previous version of the guidelines [4].
Abstract
In 2011 a working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines for Tourette syndrome (TS). Now, we present an updated version 2.0 of these European clinical guidelines for Tourette syndrome and other tic disorders, part I: assessment. Therefore, the available literature has been thoroughly screened, supplemented with national guidelines across countries and discussions among ESSTS experts. Diagnostic changes between DSM-IV and DSM-5 classifications were taken into account and new information has been added regarding differential diagnoses, with an emphasis on functional movement disorders in both children and adults. Further, recommendations regarding rating scales to evaluate tics, comorbidities, and neuropsychological status are provided. Finally, results from a recently performed survey among ESSTS members on assessment in TS are described. We acknowledge that the Yale Global Tic Severity Scale (YGTSS) is still the gold standard for assessing tics. Recommendations are provided for scales for the assessment of tics and psychiatric comorbidities in patients with TS not only in routine clinical practice, but also in the context of clinical research. Furthermore, assessments supporting the differential diagnosis process are given as well as tests to analyse cognitive abilities, emotional functions and motor skills.
Contents of the original publication
The section headings of the original.
- Introduction
- Methods
- Prevalence
- Course and course prediction of tics and comorbidities
- Diagnosing
- Classifications
- Characteristics of tics
- Role of genetics in the diagnosis of tic disorders
- Tic-related phenomena
- Compulsive tics/tic-like behaviours and impulsive tics
- Self-injurious behaviours
- Quality of life in TS
- Comorbidities
- OCD and ADHD
- Autism spectrum disorder (ASD)
- Rage attacks
- Neuropsychological impairments
- Differential diagnosis
- Other hyperkinetic movement disorders
- Stereotypies
- Functional movement disorders and vocalisations
- Somatic conditions
- PANS/PANDAS
- Work-up
- General evaluation
- Physical examination
- Parent- and patient rating scales to support the general evaluation
- Specific evaluation
- Clinical interview
- Assessment of tics
- Interviews to establish the diagnosis
- Ratings of tic severity
- Assessment of quality of life in TS
- Assessment of comorbidities
- Other comorbidities: OCD, anxiety, mood, rage attacks
- Assessment of neuropsychological functioning
- Conclusions
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