Rage attacks and aggressive symptoms in Japanese adolescents with tourette syndrome.

Objective: This study was conducted to explore possible causes of rage attacks as well as clinically significant aggressive symptoms in Japanese adolescents with Tourette syndrome (TS).

Methods: The subjects included 29 adolescents (23 males, 6 females; mean age: 13.5+/-3.7 years). Eighteen subjects (62.1%) were diagnosed with TS only, 11 (37.9%) with TS and comorbidities, including attention-deficit/hyperactivity disorder and obsessive-compulsive disorder. Parents completed the Child Behavior Checklist. Clinically significant aggressive symptoms were assessed using two pilot tools, the Rage Screen and Questionnaire and the Clinical Rating of Aggression.

Results: Thirteen subjects (44.8%) were judged to have clinically significant aggressive symptoms, according to the Clinical Rating of Aggression. Twelve met criteria for recurrent rage attacks, according to the Rage Screen and Questionnaire. Between the 13 aggressive and 16 non-aggressive subjects, no significant differences were found in age, gender, psychiatric comorbidities, or concurrent medication. Child Behavior Checklist ratings to compare 11 aggressive and 12 non-aggressive subjects <16 years of age revealed elevated t-test scores on the anxious/depressed, thought problems, aggressive, internalizing, externalizing subscales, and total scale in the aggressive group versus the non-aggressive group.

Conclusion: Rage attacks and clinically significant aggressive symptoms are common problems in Japanese TS youth. Psychiatric morbidity appears associated with impulsive-aggressive symptoms. Treatment implications from these findings need to be explored further.