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November 1987

Tourette's Syndrome and Attention Deficit Disorder With Hyperactivity-Reply

Author Affiliations

Child Study Center and Department of Human Genetics; Child Study Center; Department of Human Genetics Yale University School of Medicine IG 82 Sterling Hall of Medicine New Haven, CT 06510-8009

Arch Gen Psychiatry. 1987;44(11):1025-1026. doi:10.1001/archpsyc.1987.01800230105018

In Reply.—  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