Comings and Comings offer four points that, in their view, support their assertion that TS and ADDH are genetically related and argue against ascertainment bias as an explanation for the high percentage of patients with TS also noted to have ADDH.Resolution of the questions relative to TS and ADDH must involve resolution of the following three different phenomena: (1) simultaneous occurrence of two independent disorders (TS and ADDH) in a single individual; (2) two different disorders having the same cause; and (3) a set of symptoms being either indicative of a specific disorder (ADDH) or merely additional symptoms in a complex syndrome (TS).In their letter, Comings and Comings confuse these phenomena. In their first point, they argue that since approximately half of the 1473 patients with TS in the literature have concomitant ADD/H, ascertainment bias cannot account for the elevated rate. It must be pointed out that
Pauls DL, Hurst CR, Leckman JF, Cohen DJ, Kruger SD, Kidd KK. Tourette's Syndrome and Attention Deficit Disorder With Hyperactivity-Reply. Arch Gen Psychiatry. 1987;44(11):1025–1026. doi:10.1001/archpsyc.1987.01800230105018
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