Tratamiento farmacológico para el trastorno por déficit de atención con hiperactividad (TDAH) en niños con tics comórbidos
References
Referencias de los estudios incluidos en esta revisión
Referencias de los estudios excluidos de esta revisión
Referencias adicionales
Referencias de otras versiones publicadas de esta revisión
Characteristics of studies
Characteristics of included studies [ordered by study ID]
Jump to:
| Methods | Double‐blind, parallel‐group study | |
| Participants | Country: USA Inclusion criteria: children aged 7‐17 years, meeting APA 2000 criteria for ADHD and TS or chronic motor tic disorder Mean age: 11.2 (SD 2.5) years Sample size: 148 (placebo = 72, atomoxetine = 76) Sex: 131 boys, 17 girls | |
| Interventions | Intervention: atomoxetine Dose: 0.5‐1.5 mg/kg per day Control: placebo Administration: administered in a divided dose, once in the morning and once in the late afternoon, for 18 weeks under double‐blind conditions | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding: funded by Eli Lilly and Company Author affiliations:
Conflicts of interest:
| |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Comment: no details provided |
| Allocation concealment (selection bias) | Low risk | Comment: randomization carried at visit 2 by a computerized interactive voice response system |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Low risk | Comment: incomplete outcome data addressed |
| Selective reporting (reporting bias) | Low risk | Comment: all expected outcomes included |
| Other bias | High risk | Comment: high rate of early treatment termination in both treatment groups at 12 weeks |
| Methods | Double‐blind, placebo‐controlled, cross‐over study of methylphenidate and dextroamphetamine | |
| Participants | Country: USA Inclusion criteria: children aged 6‐13 years, meeting APA 1987 criteria for ADHD and Tourette syndrome Mean age: 9.4 (SD 2.0) years Sample size: 22 Sex: all boys | |
| Interventions | Intervention: methylphenidate and dextroamphetamine, each at 3 possible doses Dose: methylphenidate: 15 mg (low), 25 mg (medium) and 45 mg (high); dextroamphetamine: 7.5 mg (low), 15 mg (medium) and 22.5 mg (high) Control: placebo Administration: doses were given twice daily at breakfast and lunch for a 1‐week period for each sequence. 1 group of 12 boys was given drug dosages in a low, medium, and high sequence for 1 week each. 1 group of 6 boys was given drug dosages in a low, medium, and medium sequence for 1 week each. 1 group of 4 boys was given drug dosages in a low, high, and high sequence for 1 week each. | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding: no information Author affiliations:
Conflicts of interests: no information | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Comment: not described |
| Allocation concealment (selection bias) | Unclear risk | Comment: not described |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Unclear risk | Comment: little raw data provided |
| Selective reporting (reporting bias) | High risk | Comment: did not include all expected outcomes. No measure of ADHD inattentive symptoms or parent report of ADHD symptoms included |
| Other bias | Low risk | Comment: no other bias apparent |
| Methods | Randomized, double‐blind, placebo‐controlled, cross‐over study | |
| Participants | Country: USA Inclusion criteria: children aged 7‐16 years, meeting APA 1987 criteria for Tourette syndrome and ADHD Mean age: 12 years Sample size: 24 Sex: 21 boys, 3 girls | |
| Interventions | Intervention: deprenyl Dose: 5 mg twice daily Control: placebo Administration: 2 × 8‐week treatment periods separated by 6‐week washout period. Participants given deprenyl or placebo for 8 weeks, followed by cross‐over to the alternate treatment after a washout period of 6 weeks | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding: no information Author affiliations:
Conflicts of interest: no information | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Comment: randomization plan generated by a Fortran program |
| Allocation concealment (selection bias) | Unclear risk | Comment: not described |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Unclear risk | Comment: not clear if those who dropped out of the study had their data included in the analysis. Very high dropout rate after first period, especially in treatment group |
| Selective reporting (reporting bias) | Low risk | Comment: all expected outcomes included |
| Other bias | Low risk | Comment: no other bias apparent |
| Methods | Double‐blind, cross‐over study | |
| Participants | Country: USA Inclusion criteria: children aged 6‐12 years, meeting APA 1987 or APA 2000 criteria for ADHD and chronic motor tic disorder or TS Mean age: 8.95 (± 1.4) years Sample size: 71 Sex: 57 boys, 14 girls | |
| Interventions | Intervention: methylphenidate Dose: 0.1 mg/kg, 0.3 mg/kg, 0.5 mg/kg Control: placebo Administration: participants received placebo and 3 doses of methylphenidate (0.1 mg/kg, 0.3 mg/kg, and 0.5 mg/kg) for 2 weeks each. Medication was administered twice daily in the aforementioned dose, 3.5 hours apart, 7 days per week for 2 weeks | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding: funded, in part, by a research grant from the Tourette Syndrome Association and United States Public Health Service grant number MH 45358 from the NIMH. Author affiliations: all of the authors are with the Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, NY Conflicts of interests: no information | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Comment: dose schedules assigned on a random basis |
| Allocation concealment (selection bias) | Low risk | Comment: details provided in paper referenced in the methods section of study manuscript |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Unclear risk | Comment: did not explain how incomplete data sets were handled |
| Selective reporting (reporting bias) | Low risk | Comment: all expected outcomes included |
| Other bias | Low risk | Comment: no other bias apparent |
| Methods | Randomized, placebo‐controlled, parallel‐group study of guanfacine versus placebo | |
| Participants | Country: USA Inclusion criteria: children aged 7‐15 years, meeting APA 2000 criteria for ADHD and a chronic tic disorder Mean age: 10.4 (SD 2.0) years Sample size: 34 (placebo = 17, guanfacine = 17) Sex: 31 boys, 3 girls | |
| Interventions | Intervention: guanfacine Dose: 1.5‐3 mg per day Control: placebo Administration: divided into 3 daily doses, for 8 weeks | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding: funded, in part, by grant number MO1‐RR‐06022, from the Children's Clinical Research Center; Mental Health Research Center grant number MH‐30929; and grant from the Tourette Syndrome Association Author affiliations: authors from the Yale Child Study Center, New Haven, CT Conflicts of interests: no information | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Comment: not described |
| Allocation concealment (selection bias) | Unclear risk | Comment: not described |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Low risk | Comment: incomplete outcome data addressed |
| Selective reporting (reporting bias) | Low risk | Comment: all expected outcomes included |
| Other bias | Low risk | Comment: no other bias apparent |
| Methods | Randomized, placebo‐controlled, cross‐over study of clonidine and desipramine | |
| Participants | Inclusion criteria: children aged 7‐14 years, meeting APA 1980 and APA 1987 criteria for TS and ADHD Mean age: 10.6 years Sample size: 34 Sex: 31 boys and 3 girls | |
| Interventions | Country: USA Intervention: clonidine, desipramine Dose: clonidine 0.05 mg, desipramine 25 mg Control: placebo Administration: given 4 times daily for 6 weeks. 1‐week washout period between treatments | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding: funded by grants from the Tourette Syndrome Association and the United States Public Health Service (grant numbers NS 27327 and HD 25806) Author affiliations: authors from the Departments of Neurology and Pediatrics at Johns Hopkins University School of Medicine, Baltimore, MD Conflicts of interest: no information | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Comment: not described |
| Allocation concealment (selection bias) | Low risk | Comment: medications, prepared by the Johns Hopkins Hospital pharmacy, provided as uniform‐appearing capsules in numbered containers |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Low risk | Comment: incomplete outcome data addressed |
| Selective reporting (reporting bias) | High risk | Comment: not all expected outcomes included. Outcome data not provided for many variables. Often reported 'male only' results |
| Other bias | Low risk | Comment: no other bias apparent |
| Methods | Double‐blind, parallel‐group trial of desipramine versus placebo | |
| Participants | Country: USA Inclusion criteria: children aged 5‐17 years, with APA 2000 diagnosis of ADHD and TS or chronic motor tic disorder Mean age: not provided for overall sample; desipramine: 10.6 (SD 2.4) years, placebo: 11.3 (SD 3.0) years Sample size: 41 (placebo = 20, desipramine = 21) Sex: 34 boys, 7 girls | |
| Interventions | Intervention: desipramine Dose: titrated weekly up to 3.5 mg/kg Control: placebo Administration: given twice daily (maximum dose split into two doses) for 6 weeks | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding: funded partly by the Tourette Sydrome Association and grant number R29 MH57511 from the NIMH, Bethesda, MD Author affiliations:
Conflicts of interest: no information | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Pharmacy randomized participants using separate balanced randomization" |
| Allocation concealment (selection bias) | Low risk | Quote: "Randomization codes were kept in sealed envelopes in the medical records. Medication was given in identical appearing 25 mg capsules." |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Low risk | Comment: incomplete outcome data addressed |
| Selective reporting (reporting bias) | Low risk | Comment: all expected outcomes included |
| Other bias | Low risk | Comment: no other bias apparent |
| Methods | Randomized, controlled, parallel‐group study of clonidine, methylphenidate, clonidine plus methylphenidate or placebo | |
| Participants | Country: USA Inclusion criteria: children aged 7‐14 years, meeting DSM‐IV criteria for ADHD and a chronic tic disorder Mean age: not provided for overall sample; placebo: 9.7 (SD 1.8) years, methylphenidate: 10.7 (SD 2.0) years, clonidine: 9.7 (SD 1.8) years, clonidine plus methylphenidate: 10.6 (SD 1.9) years Sample size: 136 (placebo = 32, methylphenidate = 37, clonidine = 34, clonidine plus methylphenidate = 33) Sex: 85% boys | |
| Interventions | Intervention: clonidine, methylphenidate Dose: flexible. Mean dose:
Control: placebo Administration: 2‐3 times per day for 16 weeks | |
| Outcomes |
| |
| Notes | Study start and end dates: no information Funding:
Author affiliations: no information Conflicts of interest: no information | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Comment: randomly assigned by central co‐ordinating center. Computer‐generated randomization plan |
| Allocation concealment (selection bias) | Low risk | Comment: central co‐ordinating center |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of participants and personnel (performance bias) | Low risk | Comment: double blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Comment: double blinded |
| Incomplete outcome data (attrition bias) | Low risk | Comment: incomplete outcome data addressed |
| Selective reporting (reporting bias) | Low risk | Comment: all expected outcomes included |
| Other bias | Low risk | Comment: no other bias apparent |
ADHD: attention deficit hyperactivity disorder; APA: American Psychiatric Association; CGI: Clinical Global Impression; DSM‐III‐R: Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised; DSM‐IV: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; IOWA: inattention/overactivity with aggression; NIMH: National Institute of Mental Health; NINDS: National Institute of Neurological Disorders and Stroke; SD: standard deviation; TS: Tourette syndrome.
Characteristics of excluded studies [ordered by study ID]
Jump to:
| Study | Reason for exclusion |
| Primary outcome to assess immediate effect of a single transdermal dose of nicotine on tics and objective indices of sustained attention. Participants did not have to have ADHD to participate in study | |
| Study excluded participants with Tourette syndrome | |
| Study did not use double‐blind procedures | |
| Study retracted from journal due to suspicion of fraudulent results and plagiarism | |
| Study looked at the effect of stimulant withdrawal on tics rather than the effect of the medication on ADHD and tic symptom severity | |
| Study on the effect of pimozide on cognition. Not all participants had ADHD |
ADHD: attention deficit hyperactivity disorder.
Study flow diagram illustrating the process for inclusion of studies.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
| Methylphenidate compared with placebo for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders | ||||
| Patient or population: children with ADHD and comorbid tic disorders Intervention: methylphenidate Comparison: placebo | ||||
| Outcomes | Effect of treatment | Number of participants | Quality of the evidence | Comments |
| ADHD symptom‐related behavior Measured by standardized rating scales: Conners' Abbreviated Teacher Rating Scale, Conners' Abbreviated Parent Rating Scale, IOWA Conners' Teacher Rating Scale, Mothers' Objective Method for Subgrouping, Continuous Performance Task, Conners' Teacher Rating Scale, Conners' Continuous Performance Task | Tourette's Syndrome Study Group 2002 showed a significant treatment effect using the Conners' Abbreviated Teacher Rating Scale (3.3 points, 98.3% CI −0.2 to 6.8; P = 0.02). | 229 (3 studies) | ⊕⊕⊝⊝ | – |
| Gadow 2007 showed that all doses (0.1 mg/kg, 0.3 mg/kg, 0.5 mg/kg) of methylphenidate were superior to placebo on all rating scales (Conners' Abbreviated Teacher/Parent Rating Scale, IOWA Conners' Teacher Rating Scale, Mothers' Objective Method for Subgrouping, Continuous Performance Test), with a dose‐dependent effect (F = 24.7; P = 0.001) | ||||
| Castellanos 1997 showed significantly decreased hyperactivity at all doses (15 mg, 25 mg, 45 mg). | ||||
| Tic severity Measured by standardized rating scales: Yale Global Tic Severity Scale, Tourette Syndrome Severity Scale, Tourette Syndrome Clinical Global Impression Scale, Global Tic Rating Scale, 2‐Minute Tic and Habit Count, Tic Symptom Self‐Report | Tourette's Syndrome Study Group 2002 found a significant treatment effect using the Yale Global Tic Severity Scale (11.0 points, 98.3% CI 2.1 to 19.8; P = 0.003). | 229 (3 studies) | ⊕⊕⊝⊝ | – |
| Gadow 2007 found no difference on the Yale Global Tic Severity Scale but found an improvement in tic severity at all doses (0.1 mg/kg, 0.3 mg/kg, 0.5 mg/kg) on the Global Tic Rating Scale completed by teachers (F = 5.33; P = 0.002) | ||||
| Castellanos 1997 found no effect of drug on tic severity for second and third cohorts. Tic severity was significantly greater during week 2 in the first cohort (P < 0.01) | ||||
| ADHD: attention deficit hyperactivity disorder; CI: confidence interval. | ||||
| GRADE Working Group grades of evidence | ||||
| aDowngraded two levels due to limitations in study design and implementation, and imprecision of results. | ||||
| Clonidine compared with placebo for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders | ||||
| Patient or population: children with ADHD and comorbid tic disorders Intervention: clonidine Comparison: placebo | ||||
| Outcomes | Effect of treatment | Number of participants | Quality of the evidence | Comments |
| ADHD symptom‐related behavior Measured by standardized rating scales: Conners' Abbreviated Teacher Rating Scale, Conners' Abbreviated Parent Rating Scale, IOWA Conners' Teacher Rating Scale, Conners' Continuous Performance Task, Child Behaviour Checklist, Gordon Diagnostic System, Clinical Evaluation of Language Function, Matching Familial Figures Test, Porteus Maze Test, Restricted Academic Test | Tourette's Syndrome Study Group 2002 found a significant treatment effect using the Conners' Abbreviated Teacher Rating Scale (3.3 points, 98.3% CI −0.2 to 6.8; P = 0.02). | 170 (2 studies) | ⊕⊕⊝⊝ | – |
| Singer 1995 found no significant difference on any ADHD outcome measures, except the nervous/overactive subscale of the Child Behaviour Checklist (boys aged 6‐11 years). | ||||
| Tic severity Measured by standardized rating scales: Yale Global Tic Severity Scale, Tourette Syndrome Severity Scale, Global Tic Rating Scale, Tic Symptom Self‐Report, Hopkins Motor/Vocal Scale | Tourette's Syndrome Study Group 2002 showed a significant treatment effect using the Yale Global Tic Severity Scale (10.9 points, 98.3% CI 2.1 to 19.7; P = 0.003). | 170 (2 studies) | ⊕⊕⊝⊝ | – |
| Singer 1995 found no significant difference on measures of tic severity. | ||||
| ADHD: attention deficit hyperactivity disorder; CI: confidence interval. | ||||
| GRADE Working Group grades of evidence | ||||
| aDowngraded two levels due to limitations in study design and implementation, and imprecision of results. | ||||
| Desipramine compared with placebo for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders | ||||
| Patient or population: children with ADHD and comorbid tic disorders Intervention: desipramine Comparison: placebo | ||||
| Outcomes | Effect of treatment | Number of participants | Quality of the evidence | Comments |
| ADHD symptom‐related behavior Measured by standardized rating scales: Child Behaviour Checklist, Gordon Diagnostic System, Clinical Evaluation of Language Function, Matching Familial Figures Test, Porteus Maze Test, Restricted Academic Test, ADHD Rating Scale IV ‐ Parent Version; ADHD Parent Linear Analogue Scale | Spencer 2002 showed a decrease in scores on the ADHD Rating Scale IV ‐ Parent Version (week 0 = 46 (SD 5.9) points; week 6 = 24 (SD 12) points; P < 0.001). | 75 (2 studies) | ⊕⊝⊝⊝ | – |
| Singer 1995 showed that desipramine was superior to placebo on the Parent Linear Analogue Scale for Hyperactivity (desipramine: 32.8 (SD 1.3) points; placebo: 64.4 (SD 0.6) points; P < 0.05). Hyperactivity subscale of the Child Behavior Checklist showed drug effects for males aged 6 to 11 years (desipramine: 68.6 (SD 1.4) points; placebo: 75.8 (SD 1.0) points; P < 0.05). | ||||
| Tic severity Measured by standardized rating scales: Yale Global Tic Severity Scale, Tourette Syndrome Severity Scale, Hopkins Motor/Vocal Scale; ADHD Parent Linear Analogue Scale | Spencer 2002 showed a decrease in scores on the Yale Global Tic Severity Scale (week 0 = 63 (SD 18) points; week 6: 43 (SD 23) points; P < 0.001). | 75 (2 studies) | ⊕⊝⊝⊝ | – |
| Singer 1995 showed that desipramine was superior to placebo on the Parent Linear Analogue Scale of tic severity (desipramine: 30.0 (SD 0.7) points; placebo: 47.4 SD 1.8 points; P < 0.05). There were no differences on the other measures of tic severity (Tourette Syndrome Severity Scale, Hopkins Motor/vocal scale, Yale Global Tic Severity Scale). | ||||
| ADHD: attention deficit hyperactivity disorder; SD: standard deviation. | ||||
| GRADE Working Group grades of evidence High quality: we are very confidence that the true effect lies close to that of the estimate of the effect. | ||||
| aDowngraded two levels due to limitations in study design and implementation, and imprecision of results. | ||||
| Comparisons | Trial(s) |
| Methylphenidate versus placebo | |
| Clonidine versus placebo | |
| Methylphenidate plus clonidine versus placebo | |
| Dextroamphetamine versus placebo | |
| Guanfacine versus placebo | |
| Atomoxetine versus placebo | |
| Desipramine versus placebo | |
| Deprenyl versus placebo | |
| Desipramine versus clonidine |
| Scale/measure | ||||||||
| Conners Abbreviated Teacher Rating Scale | – | – | – | Yes | – | – | – | Yes |
| Conners Abbreviated Parent Rating Scale | – | – | – | Yes | – | – | – | Yes |
| IOWA Conners Teacher Rating Scale | – | – | – | Yes | – | – | – | Yes |
| Mothers' Objective Method for Subgrouping | – | – | – | Yes | – | – | – | – |
| Continuous Performance Task | – | – | – | Yes | Yes | – | – | – |
| ADHD Rating Scale‐IV: Parent Version | Yes | – | – | – | Yes | – | Yes | – |
| Clinical Global Impression Scale – Overall – Severity | Yes | – | – | – | Yes | – | – | – |
| Clinical Global Impression Scale – ADHD/Psychiatric Symptoms | Yes | – | – | – | – | – | – | – |
| ADHD Teacher 39‐Item Conners Rating Scale | – | Yes | – | – | – | – | – | – |
| DuPaul ADHD Scale | – | – | Yes | – | – | – | – | – |
| Parent Conners Questionnaire Hyperactivity Index | – | – | – | – | Yes | – | – | – |
| Child Behaviour Checklist | – | – | – | – | – | Yes | – | – |
| Gordon Diagnostic System | – | – | – | – | – | Yes | – | – |
| Clinical Evaluation of Language Function | – | – | – | – | – | Yes | – | – |
| Matching Familial Figures Test | – | – | – | – | – | Yes | – | – |
| Porteus Maze Test | – | – | – | – | – | Yes | – | – |
| Restricted Academic Test | – | – | – | – | – | Yes | – | – |
| Conners Continuous Performance Task | – | – | – | – | – | – | – | Yes |
| ADHD: attention deficit hyperactivity disorder; IOWA: inattention/overactivity with aggression. | ||||||||
| Scale/measure | ||||||||
| Yale Global Tic Severity Scale | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Tourette Syndrome Severity Scale | – | – | – | Yes | – | Yes | – | – |
| Tourette Syndrome Clinical Global Improvement | Yes | – | – | Yes | – | – | – | – |
| Global Tic Rating Scale | – | – | – | Yes | – | – | – | Yes |
| 2‐Minute Tic and Habit Count | – | – | – | Yes | – | – | – | – |
| Tic Symptom Self‐Report | Yes | – | – | – | – | – | – | Yes |
| Goetz Tic Severity Scale | – | – | Yes | – | – | – | – | – |
| Hopkins Motor/Vocal Scale | – | – | – | – | – | Yes | – | – |
| Scale/measure | Number of items | Scoring |
| Conners' Abbreviated Symptoms Questionnaire for Teachers (ASQ) | 10 items pertaining to the child's behavior | Rated on a 4‐point Likert scale, ranging from 0 (not at all), 1 (just a little), 2 (pretty much) to 3 (very much true), with a possible total score ranging from 0 to 30. Higher scores indicate worse symptoms |
| Yale Global Tic Severity Scale (YGTSS) | 5 items on the number, frequency, intensity, complexity, and interference from motor tics, and 5 items on the number, frequency, intensity, complexity, and interference from vocal tics, and 1 item on overall impairment | The Total Motor Tic Score is derived by adding the 5 motor tics items (each item ranges from 0 to 5, total motor tic score ranges from 0 to 25). The Total Vocal Tic Score is derived by adding the 5 phonic tics items (each item ranges from 0 to 5, total vocal tic ranges from 0 to 25). The Total Tic Score is a summation of the Total Motor Tic and Total Vocal Tic Scores. The Overall Impairment Rating is rated on a 51‐point scale anchored by 0 (no impairment) and 50 (severe impairment). Finally, the Global Severity Score is a summation of the Total Motor Tic Score, Total Vocal Tic Score, and Overall Impairment Rating (range 0 to 100). Higher scores indicate worse symptoms. |
| Global Tic Rating Scale | 9 items, with the first 5 referring to the frequency of motor (3 items) and phonic tics (2 items) according to body region, which are summed to produce motor and phonic tic frequency subscores, respectively | All items are rated on a scale from 0 (never) to 3 (very much). Total score ranges from 0 to 27. Higher scores indicate worse symptoms |
| ADHD Rating Scale IV ‐ Parent Version | 18‐item questionnaire. 9 questions each on inattention and hyperactivity‐impulsivity, where the odd‐numbered items represent the inattention subscale, and the even‐numbered items represent the hyperactive/impulsive subscale | Items coded on 4‐point Likert scale using scores 1 (never or rarely), 2 (sometimes), 3 (often), or 4 (very often). Total score ranges from 18 to 52. Raw scores are converted to percentiles. |
| ADHD Parent Linear Analogue Scale | 10‐cm line on which both the parent and physician separately rank symptoms | The ends of each line represent 0 (no symptoms) and 10 (most severe) |
| Child Behaviour Checklist (CBCL) | 113 items across 8 subscales assessing maladaptive behavioral and emotional problems:
| Items are coded from 0 to 2, scored 0 (not at all), 1 (somewhat true), or 2 (very true). CBCL profile for each category, with scores below the 95th percentile in the normal range, and above the 98th percentile in the clinical range. Higher scores indicate worse symptoms. |
| Conners' Abbreviated Parent Rating Scale | 48 items across 6 subscales:
| All items are rated on a scale from 0 (never) to 3 (very much). Total score ranges from 0 to 144. Higher scores indicate worse symptoms |
| IOWA Conners' Teacher Rating Scale | 10 items. Consists of 5‐item subscales designed to assess inattention/overactivity and aggression Inattention/overactivity:
Aggression:
| Scored 0 (not at all), 1 (just a little), 2 (pretty much), or 3 (very much). Total score ranges from 0 to 30. Higher scores indicate worse symptoms |
| Mothers' Objective Method for Subgrouping | Contains 10 (hyperactivity or ADHD, or both) symptoms arranged in a checklist format. Generates a hyperactivity scale score and an aggression scale score | 1 indicates checked and 0 unchecked. Total score ranges from 0 to 10. Higher scores indicate worse symptoms |
| Continuous Performance Task (CPT) | Computer‐administered and scored measure of sustained visual attention and motor response inhibition. The test takes about 15 minutes to administer and yields measures of omissions, commissions, and reaction time. | Omission errors measure inattention, commission errors measure impulsivity |
| Conners' Teacher Rating Scale | 39 items clustered into 5 factors, including conduct problems, daydreaming, inattention, anxious‐fearful, and hyperactive behavior ADHD Teacher 39‐Item | All items are rated on a scale from 0 (never) to 3 (very much). Total score ranges from 0 to 137. Raw scores for each scale are converted to T scores, incorporating normative adjustments for age and sex, with scores of at least 70 considered clinically elevated |
| Conners' Continuous Performance Task (CPT) | Visual‐motor task. Respondents must rapidly and accurately hit the space bar after every letter presented except the letter 'X'. Several variables may be derived from the Conners' CPT, including errors of omission and commission, mean hit reaction time (RT), mean hit RT standard error. | Omission errors measure inattention, commission errors measure impulsivity |
| Tourette Syndrome Severity Scale | 5‐item scale
| Higher scores indicates worse symptoms |
| Tourette Syndrome Clinical Global Impression (CGI) Scale | Observer‐rated scale that measures illness severity (CGI‐S), or global improvement (CGI‐I) | 7‐point scale, with the severity of illness scale (CGI‐S) using a range of responses from 1 (normal) to 7 (among the most severely ill people). CGI‐I scores range from 1 (very much improved) to 7 (very much worse) |
| 2‐Minute Tic and Habit Count | The physician counts separately the number of brief, jerky (i.e. tics) and rhythmic (i.e. stereotypic, habit) movements and vocalizations during quiet conversation in an office setting. | Higher scores indicates worse symptoms |
| Tic Symptom Self‐Report | 40‐item checklist containing 20 motor tic items and 20 phonic tic items | 0–3 scale corresponding with absent (score of 0) to very frequent and forceful (score of 3). Total score ranges from 0 to 120. Higher scores indicate worse symptoms |
| Goetz Tic Severity Scale | Videotape protocol involving a 10‐minute film of people placed in front of a video camera in a quiet room. 2 body views are recorded, full frontal body (far) and head and shoulders only (near), under 2 conditions: relaxed with the examiner in the room, and relaxed with the patient alone in the room 5 domains are rated:
| 0–4 scoring format. For all domains, 0 represents normal function without evidence of tic disability. Higher scores indicate worse symptoms |
| Hopkins Motor/Vocal Scale | Consists of a series of linear analog scales (10 cm) on which both the parent and physician separately rank each tic (motor and vocal) symptom, taking into consideration its frequency, intensity, degree of interference, and impairment | The ends of each line represent 0 (no tics) and 10 (most severe). The line can be subdivided roughly into 4 ranges: mild, moderate, moderately severe, and severe |
| Du Paul ADHD Rating Scale | 14 items, assessing separate factors of inattention and hyperactivity‐impulsivity | Rated on a 0 (normal) to 3 (severe) scale, yielding a total score ranging from 0 to 42. Higher scores indicate worse symptoms |
| Parent Conners' Questionnaire Hyperactivity Index | 10‐item rating scale identifying hyperactive children | Each item is rated from 0 to 3 (range 0–30). Higher scores indicate worse symptoms |
| ADHD: attention deficit hyperactivity disorder. | ||
