Patients with Tourette syndrome (TS) or chronic tic disorder (CTD) were more likely to be victims of violent crimes or perpetrators of any crimes compared with the general population, according study findings published in JAMA Neurology.

TS and CTD often associate with other neuropsychiatric comorbidities and social disadvantages. It remains unclear whether these factors may increase risk for involvement with the criminal justice system.

In order to understand whether patients with TS and CTD are either perpetrators or victims of crimes more than the general public, data were sourced from the Swedish national identification number liked with the nationwide health and administrative registers. Individuals living in Sweden between 1973 and 2013 (N=13,819,284) were evaluated for lifetime diagnoses of TS or CTD and whether they were convicted of or were a victim of a crime.


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A total of 7791 individuals were diagnosed with TS or CTD during the study period. The population was 76% men or boys, aged median 13.4 (interquartile range [IQR], 10.0-21.8) years at diagnosis, and most had at least 1 comorbid psychiatric disorder.

After adjusting for gender and birth year, individuals with TS or CTD were more than 2 times as likely (adjusted hazard ratio [aHR], 2.21; 95% CI, 2.00-2.43) to be the victim of a violent assault compared with the general population. Women (aHR, 4.40) and men (aHR, 3.10) with TS or CTD were more likely to be victims of a sexual assault and of a nonsexual assault (women: aHR, 2.57; men: aHR, 1.88).

The population of patients with TS or CTD were more than 3 times as likely (aHR, 3.13; 95% CI, 2.92-3.36) to be convicted of a violent assault than the general population. The patient population was more likely to be convicted of nonviolent (aHR, 1.62), alcohol– or drug-related (aHR, 2.10), traffic (aHR, 1.45), property (aHR, 2.06), and other (aHR, 2.00) offenses. Stratified by gender, women had higher HRs for all types of crimes.

Compared with their siblings, the population of individuals with TS and CTD were still more likely to be victims or perpetrators of crimes.

In sensitivity analyses, which excluded certain patients with comorbid psychiatric disorders, all populations were at increased risk for being victims or perpetrators of crimes, except when excluding those with comorbid attention-deficit/hyperactive disorder; the population was no more likely to be convicted of a traffic crime (HR, 1.08; 95% CI, 0.96-1.23) than the general public.

This study was limited by defining violent crimes as incidence which required medical intervention.

These data indicated that individuals with TS or CTD were more likely to both be victims of any crime and perpetrators of violent crime than either the general population or their siblings.

“Future studies should focus on understanding the etiology of such serious outcomes in an effort to prevent the experience of assault or criminal convictions in individuals with TS or CTD,” the researchers concluded.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Mataix-Cols D, Virtanen S, Sidorchuk A, et al. Association of Tourette Syndrome and Chronic Tic Disorder With Violent Assault and Criminal Convictions. JAMA Neurol. Published online March 21, 2022. doi:10.1001/jamaneurol.2022.0167

This article originally appeared on Psychiatry Advisor