To determine associations among tic severity and function in youth with Tourette Syndrome (TS) and coprophenomena compared to those with TS without coprophenomena. 

TS is defined by multiple motor tics and one or more phonic tics with symptom duration of >1 year. Coprophenomena are uncommon tics characterized by obscene sounds, words, or gestures. Children with TS have reported lower scores on measures of individual and family functioning than youth without TS. It is not known whether or how coprophenomena impacts function or quality of life (QOL) in youth with TS.

The University of Rochester and University of South Florida jointly conducted a CDC-funded cross-sectional Tic Impact Study. Data were collected from children with TS and their caregivers and teachers. Family impact was measured in domains of parent health-related quality of life (HRQOL), family functioning, and total family impact. We conducted analyses to compare global and family function in youth with TS with (TS+copro) and without (TS-copro) coprophenomena. Wilcoxon rank-sum tests were used to compare scores on individual function and family function measures.

Of 170 subjects, 17(10%) exhibited coprophenomena. Subjects with TS and coprophenomena had higher tic severity scores than those without coprophenomena (TS+copro mean(SD) = 36.9(7.5), TS-copro = 20.8(8.3), p<0.0001). Patients with coprophenomena had lower scores for global function (TS+copro median (IQR) = 51 (45,59), TS-copro = 60 (52,65), p = .0042), family functioning (TS+copro = 43.8 (25,62.5), TS-copro = 59.4 (46.9,84.4), p = .0007), parent HRQOL (TS+copro = 57.5 (38.1,61.3), TS-copro = 72.5 (56.3,86.3), p = .0003), and total family QOL (TS+copro = 50.7 (38.2,58.7), TS-copro = 65.3 (54.2,80.6), p = .0042). 

Youth with TS and coprophenomena had lower individual function, family function, and parent HRQOL than youth without coprophenomena. Coprophenomena presence may represent a more severe phenotype of TS and may be an indicator for earlier intervention.