OBJECTIVETo explore risk factors of patients with Tourette syndrome (TS) to develop the comorbidity attention-deficit hyperactivity disorder (ADHD) (TS + ADHD), so as to provide evidence for its prevention and intervention.

METHODSA total of 150 patients with TS were divided into two groups (TS group; TS + ADHD group) according to DSM-IV with 75 patients in each group. All the enrolled patients were investigated using self-designed questionnaire and Family Environment Scale-Chinese Edition (FES-CV). Forty-six factors were used as variables and were quantified. Data were analyzed by SPSS10.0 and the odds ratios of different factors to TS + ADHD were calculated by using univariate and multivariate analysis.

RESULTS(1) Families of children with TS + ADHD had lower score in cohesion, expression, intellectual-cultural orientation, active-recreational orientation, moral religious emphasis and organization, but had higher conflict score in FES-CV than the control group. (2) Single-factor analysis indicated that 8 factors were associated with TS + ADHD including ADHD family history positive (OR = 24.318), low family education (OR = 18.617), longer delay of treatment (OR = 10.796), maternal smoking (OR = 9.094), family conflict (OR = 5.781), hypoxia at birth (OR = 2.562), lower culture level of parents (OR = 1.941) and poor expressiveness (OR = 0.967). (3) Five factors including ADHD family history positive (OR = 13.805), family conflict (OR = 8.459), low family education (OR = 5.477), lower culture level of parents (OR = 2.164) and maternal smoking (OR = 2.075) were selected for the multivariate regression analysis.

CONCLUSIONThe key risk factors of co-occurrence of TS with ADHD were positive ADHD family history, family conflict, low family education, lower culture level of parents and maternal smoking.