BIOLOGICAL CHILD AND ADOLESCENT PSYCHIATRY - SHORT COMMUNICATION Is onset of Tourette syndrome influenced by life events? Netta Horesh Æ Sharon Zimmerman Æ Tami Steinberg Æ Haim Yagan Æ Alan Apter Received: 7 July 2007 / Accepted: 17 December 2007 / Published online: 24 January 2008 Ó Springer-Verlag 2008 Abstract The aim of this study is to investigate the possible relationship between stressful life events, person- ality, and onset of Tourette syndrome in children. The study group included 93 subjects aged 7–18 years: 41 with Tourette syndrome (TS), 28 with obsessive-compulsive disorder (OCD), and 24 healthy controls. Diagnoses were based on the Child Schedule for Schizophrenia and Affective Disorders (K-SADS). All children were tested with the Screen for Child Anxiety Related Emotional Disorders, Children’s Yale Brown Obsessive Compulsive Scale, Beck Depression Inventory or Children’s Depression Inventory, the Life Experience Survey, and the Junior Temperament and Character Inventory. The findings were compared among the groups. Subjects with Tourette syn- drome and healthy controls had significantly less stressful life events than subjects with (OCD). There were no sig- nificant differences between the TS subjects and the healthy controls. This finding applied to total lifetime events, total lifetime negative events, and events in the year before and after illness onset. Subjects with TS and the healthy controls also showed a significantly lesser impact of life events than subjects with OCD. The Tourette syn- drome group showed a significantly lesser impact of stressful life events than controls. Harm avoidance tended to be higher in the patients with Tourette syndrome and comorbid attention deficit hyperactivity disorder and obsessive-compulsive disorder than in patients with Tou- rette syndrome only. There seemed to be no association between life events, diagnosis, and personality. Although there is some research suggesting that tics can be influ- enced by the environment, the onset of Tourette syndrome does not seem to be related to stressful life events, nor to an interaction between stressful life events and personality. Introduction It is now generally accepted that the occurrence of psy- chiatric disorders cannot be understood by focusing on factors from a single domain only (such as the biologic, psychological or social) (Perris 1991). Today, most views on psychopathology are based on stress–diathesis interac- tions (Monroe and Simmons 1991). Thus, the role of non- shared environmental factors in the pathogenesis of mental illness is an intriguing area of research, recently rendered highly relevant by advances in the study of molecular genetics (Caspi et al. 2003). The environmental factors related to stress and, more particularly, stressful life events (SLE), have been the most widely studied (Caspi 2003). The study of SLE is complex and controversial, and several different approaches have been suggested. In the ‘‘objective approach’’, espoused by Dohrenwend (1985), stress is considered an environmental input independent of the person’s reaction or emotional state. By contrast, the ‘‘relational-cognitive-orientation approach’’ of Lazarus et al. (1985) emphasizes the meaning attributed to life events by the individual. Three general theories about the N. Horesh Á H. Yagan Department of Psychology, Bar Ilan University, Ramat Gan 52900, Israel S. Zimmerman Á T. Steinberg Á H. Yagan Á A. Apter (&) Feinberg Child Study Center, Schneider Children’s Medical Center of Israel, 14 Kaplan St., Petah Tikva 49202, Israel e-mail: apter@post.tau.ac.il S. Zimmerman Á T. Steinberg Á H. Yagan Á A. Apter Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 123 J Neural Transm (2008) 115:787–793 DOI 10.1007/s00702-007-0014-3