{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:14:01Z","timestamp":1790079241975,"version":"4.0.1"},"reference-count":20,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Behavioral disturbances are common in Gilles de la Tourette syndrome (GTS) and can include risky impulsive behaviors (RIBs), but RIB classification remains unclear. This study aims to define the epidemiology of RIB in GTS and to assess its relationship with tic severity and the prevalence of comorbid psychiatric disorders. Methods: The study was structured as a cross-sectional registration study, with each patient enrolled into the database during a single clinical visit. The study included 365 participants with GTS (272 males, 74.5%), of whom 278 (76.2%) were children and adolescents. The mean age at evaluation was 14.4 \u00b1 9.8 years (range 4\u201364). Clinical data on RIB were obtained during routine outpatient visits using semi-structured questionnaires developed by the authors. Results: RIB was reported in 64 (17.6%) patients with GTS, a group composed of 19 (29.7%) adults and 45 (70.3%) minors. RIB commenced at a mean age of 8.1 \u00b1 5.4 years (range 2\u201330). The mean age at onset of RIB was 2.6 \u00b1 4.9 years after the onset of tics. Of the patients with RIB, 84.4% had at least one comorbid psychiatric disorder, whereas 15.6% of RIB patients had no psychiatric comorbidity. Multivariable logistic regression showed significant associations between RIB and YGTSS (p = 0.02, OR = 1.02), ADHD (p &lt; 0.01, OR = 2.91), and ODD (p = 0.01, OR = 3.02). Conclusions: RIB may occur early in the course of GTS, typically beginning during childhood, and was identified in 17.6% of patients. Its occurrence was associated with the presence of comorbid psychiatric disorders, particularly ADHD and ODD. Greater tic severity was also statistically associated with RIB, although the effect was small and of limited clinical significance.<\/jats:p>","DOI":"10.3390\/jcm15187335","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:09:35Z","timestamp":1790075375000},"page":"7335","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risky Impulsive Behavior in Gilles de la Tourette Syndrome"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5500-7969","authenticated-orcid":false,"given":"Mateusz","family":"Grycz","sequence":"first","affiliation":[{"name":"National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2701-191X","authenticated-orcid":false,"given":"Piotr","family":"Janik","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1002\/wps.20050","article-title":"The DSM-5: Classification and Criteria Changes","volume":"12","author":"Regier","year":"2013","journal-title":"World Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1093\/brain\/123.3.425","article-title":"Tourette Syndrome, Associated Conditions and the Complexities of Treatment","volume":"123","author":"Robertson","year":"2000","journal-title":"Brain"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Szejko, N., Jakubczyk, A., and Janik, P. (2019). Prevalence and Clinical Correlates of Self-Harm Behaviors in Gilles de la Tourette Syndrome. Front. Psychiatry, 10.","DOI":"10.3389\/fpsyt.2019.00638"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Grycz, M., and Janik, P. (2024). Non-Obscene Socially Inappropriate Behavior in Patients with Gilles de la Tourette Syndrome. J. Clin. Med., 13.","DOI":"10.3390\/jcm13195926"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5, American Psychiatric Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1176\/jnp.8.3.311","article-title":"Non-Obscene Complex Socially Inappropriate Behavior in Tourette\u2019s Syndrome","volume":"8","author":"Kurlan","year":"1996","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1016\/j.jpsychires.2013.05.019","article-title":"On Being Your Own Worst Enemy: An Investigation of Socially Inappropriate Symptoms in Tourette Syndrome","volume":"47","author":"Eddy","year":"2013","journal-title":"J. Psychiatr. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Brandt, V., Kerner Auch Koerner, J., and Palmer-Cooper, E. (2019). The Association of Non-Obscene Socially Inappropriate Behavior with Attention-Deficit\/Hyperactivity Disorder Symptoms, Conduct Problems, and Risky Decision Making in a Large Sample of Adolescents. Front. Psychiatry, 10.","DOI":"10.3389\/fpsyt.2019.00660"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11920-019-1019-y","article-title":"Risk-Taking Behavior in Attention Deficit\/Hyperactivity Disorder (ADHD): A Review of Potential Underlying Mechanisms and of Interventions","volume":"21","author":"Pollak","year":"2019","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S1474-4422(22)00303-9","article-title":"Tourette Syndrome: Clinical Features, Pathophysiology, and Treatment","volume":"22","author":"Johnson","year":"2023","journal-title":"Lancet Neurol."},{"key":"ref_11","unstructured":"Walkup, J.T., Mink, J.W., and Hollenbeck, P.J. (2006). Advances in Neurology: Tourette Syndrome, Lippincott Williams & Wilkins."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1136\/jnnp.57.7.853","article-title":"Stimulus Induced Behaviours in Tourette\u2019s Syndrome","volume":"57","author":"Eapen","year":"1994","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1111\/j.1469-8749.2000.tb00346.x","article-title":"An International Perspective on Tourette Syndrome: Selected Findings from 3500 Individuals in 22 Countries","volume":"42","author":"Freeman","year":"2000","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1542\/peds.102.1.14","article-title":"Course of Tic Severity in Tourette Syndrome: The First Two Decades","volume":"102","author":"Leckman","year":"1998","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/archpedi.160.1.65","article-title":"Adulthood Outcome of Tic and Obsessive-Compulsive Symptom Severity in Children with Tourette Syndrome","volume":"160","author":"Bloch","year":"2006","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1001\/jamapsychiatry.2016.0465","article-title":"Evaluation of the Persistence, Remission, and Emergence of Attention-Deficit\/Hyperactivity Disorder in Young Adulthood","volume":"73","author":"Polanczyk","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Babicka-Wirkus, A., Koz\u0142owski, P., Wirkus, \u0141., and Stasiak, K. (2023). Internalizing and Externalizing Disorder Levels among Adolescents: Data from Poland. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20032752"},{"key":"ref_18","unstructured":"Friedman, H.S., and Markey, C.H. (2023). Encyclopedia of Mental Health, Academic Press. [3rd ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1093\/brain\/awx204","article-title":"Tourette Syndrome: A Disorder of the Social Decision-Making Network","volume":"141","author":"Albin","year":"2018","journal-title":"Brain"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/1469-7610.00424","article-title":"Comorbidity","volume":"40","author":"Angold","year":"1999","journal-title":"J. Child Psychol. Psychiatry"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7335\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:37:05Z","timestamp":1790077025000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":20,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187335"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187335","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}