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This cross-sectional study compared serum 25-hydroxyvitamin D [25(OH)D] (ng\/ml) levels among three groups: children and adolescents (3\u201316\u00a0years) with CTD (<jats:italic>n<\/jats:italic>\u2009=\u2009327); first-degree relatives (3\u201310\u00a0years) of individuals with CTD who were assessed for a period of up to 7\u00a0years for possible onset of tics and developed tics within this period\u00a0(<jats:italic>n<\/jats:italic>\u2009=\u200931); and first-degree relatives who did not develop tics and were\u2009\u2265\u200910\u00a0years old at their last assessment (<jats:italic>n<\/jats:italic>\u2009=\u200993). The relationship between 25(OH)D and the presence and severity of tics, as well as comorbid obsessive\u2013compulsive disorder (OCD) and attention-deficit\/hyperactivity disorder (ADHD), were analysed controlling for age, sex, season, centre, latitude, family relatedness, and comorbidities. When comparing the CTD cohort to the unaffected cohort, the observed result was contrary to the one expected: a 10\u00a0ng\/ml increase in 25(OH)D was associated with higher odds of having CTD (OR 2.08, 95% CI 1.27\u20133.42, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). There was no association between 25(OH)D and tic severity. However, a 10\u00a0ng\/ml increase in 25(OH)D was associated with lower odds of having comorbid ADHD within the CTD cohort (OR 0.55, 95% CI 0.36\u20130.84, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and was inversely associated with ADHD symptom severity (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a02.52, 95% CI \u2212\u00a04.16\u20130.88, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). In conclusion,\u00a0lower vitamin D levels were not associated with a higher presence or severity of tics but\u00a0were associated with the presence and severity of comorbid ADHD in children and adolescents with CTD.<\/jats:p>","DOI":"10.1007\/s00787-021-01757-y","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T19:08:51Z","timestamp":1618340931000},"page":"1-12","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Vitamin D levels in children and adolescents with chronic tic disorders: a multicentre 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