Prognosis
Without treatment, it is expected that tics will have a waxing and waning course with exacerbations during stressful periods. The prognosis for transient tic disorder is excellent, with resolution of tics in <1 year, although this diagnosis is usually made in retrospect.
Tourette syndrome
For Tourette syndrome (Tourette disorder), the course can be quite variable. Maximum tic severity occurs between 10 and 12 years of age.[109][110] In a large prospective clinical study, data were collected for 314 patients at baseline (ages 5-19 years) and at follow-up 6 years later. Tic severity declined annually on the Yale Global Tic Severity Scale (YGTSS) during adolescence; 17.7% of participants aged >16 years had no tics, 59.5% had minimal or mild tics, and 22.8% had moderate or severe tics. Comorbidity severity also declined yearly in both obsessive-compulsive disorder and ADHD. At follow-up, 63% of participants had comorbidities or coexistent psychopathologies and 37% had pure Tourette syndrome.[111] Another study showed a 50% complete tic resolution by age 18 years. Early onset of tics and the presence of comorbidities may cause specific deficits in cognitive performance.[112]
Comorbidities
Tic disorder outcome is not associated with global well-being or with social and educational capabilities in adulthood.[2] In an observational study of 186 patients, the relationship between tic severity and the frequency of behavioral symptoms was not linear.[113] Therefore, for many patients addressing and treating their comorbidities may be more helpful than just controlling tics alone.[109]
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