Clinical Correlates of Tourette’s Disorder Across Cultures: A Comparative Study Between the United Arab Emirates and the United Kingdom

Background and Objective: Tourette’s disorder is a neuropsychiatric disorder characterized by motor and vocal (phonic) tics. While the disorder has been researched extensively in the Western populations, the clinical correlates and associated features are less well known in other populations and cultures. This study examines the presentation and clinical correlates of Tourette’s disorder in 2 distinct populations, namely the United Kingdom and the United Arab Emirates.

Method: A consecutive series of 35 Tourette’s disorder patients of Arab descent recruited from 2001 to 2005 from the Child Psychiatry clinics in Al Ain, United Arab Emirates (U.A.E.), were compared with 35 age- and gender-matched white Tourette’s disorder patients attending the Tourette Clinic at the National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom, from December 2004 to December 2005.

Results: Rates of occurrence of obsessive-compulsive disorder and attention-deficit/hyperactivity disorder were similar in the 2 cohorts. Coprolalia was higher in the U.K. cohort and was noted to correlate with the severity of Tourette’s disorder. Comorbid oppositional defiant disorder and conduct disorder were also higher in the U.K. cohort (54.3% [N = 19] and 20.0% [N = 7], respectively) as compared to the U.A.E. cohort (11.4% [N = 4] and 5.7% [N = 2], respectively) but were not linked to any other clinical feature or severity of Tourette’s disorder.

Conclusion: The findings illustrate the similarity in the core clinical symptoms between the 2 populations, thus emphasizing the underlying biological and genetic basis of these symptoms. However, our finding of higher occurrence of behavioral symptoms in the Western sample has implications for our understanding of the phenotypic presentation of Tourette’s disorder as well as the management.