Systematic Literature Review on Public Health Impacts of Tourette Syndrome and Persistent Tic Disorders: General Health, Health Conditions, and Health Behaviors.

BACKGROUND: The association of tic disorders and physical health has not been comprehensively described. This systematic review summarized the associations between indicators of physical health (e.g., health-related quality of life [HR-QoL]), health conditions, and health behaviors with Tourette syndrome (TS) and persistent tic disorders (PTD) in individuals across the lifespan. METHODS: We used multiple databases to search the literature through March 5, 2025, and identified 84 studies published in English in 2003 or later that reported health-related outcomes among individuals with TS/PTD and a comparison group without TS/PTD. In describing differences between groups, we considered statistical significance and the magnitude of the difference, particularly when statistical comparisons were not reported. Risk of bias was conducted using the Newcastle-Ottawa Scale. RESULTS: Several indicators of poor health and several health conditions were more prevalent among individuals with TS/PTD, compared with those without, including some measures of lower HR-QoL, overall poor health/disability, mortality, injuries, suicidal thoughts and behaviors, orthopedic conditions, neurological disorders, sleep disorders, endocrine conditions, immune-related disorders including asthma and allergy, and hearing and/or vision problems. Findings across studies were inconsistent for gastrointestinal and circulatory system conditions, and infection and fever. Findings did not differ by TS/PTD status for body mass index and health behaviors. Strengths and limitations of this body of literature are discussed. CONCLUSIONS: Findings from this review can be used to inform health care provider education activities and future research to improve the health and well-being of individuals with TS/PTD.