Systematic review of severity scales and screening instruments for tics: Critique and recommendations

Research output: Contribution to journalArticlepeer-review


  • Davide Martino
  • Tamara M Pringsheim
  • Andrea E Cavanna
  • Carlo Colosimo
  • Andreas Hartmann
  • James F Leckman
  • Sheng Luo
  • Alexander Munchau
  • Christopher G Goetz
  • Glenn T Stebbins
  • Pablo Martinez-Martin
  • Members of the MDS Committee on Rating Scales Development
  • Andrea Eugenio Cavanna

Colleges, School and Institutes

External organisations

  • Queen Elizabeth Hospital, Woolwich, Lewisham & Greenwich NHS Trust, London, UK.
  • Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Canada.
  • Birmingham and Solihull Mental Health National Health Service Foundation Trust, Department of Neuropsychiatry, The Barberry National Centre for Mental Health, Birmingham, UK.
  • Department of Neuroscience, University of Rome "La Sapienza,", Rome, Italy.
  • Centre de Reference National Maladie Rare: "Syndrome Gilles de la Tourette," Departement de Neurologie, Pole des Maladies du Systeme Nerveux, Paris, France.
  • Child Study Center, Yale University, New Haven, Connecticut, USA.
  • Department of Biostatistics, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institut of Neurogenetics, University of Lübeck, Lübeck, Germany.
  • Department of Neurological Sciences, Rush University Medical Center, Chicago, Ilinois, USA.
  • National Center of Epidemiology and Centro Investigación Biomédica en Red Enfermedades Neurodegenerativas, Carlos III Institute of Health, Madrid, Spain.


BACKGROUND: Several clinician, informant, and self-report instruments for tics and associated phenomena have been developed that differ in construct, comprehensiveness, and ease of administration.

OBJECTIVE: A Movement Disorders Society subcommittee aimed to rate psychometric quality of severity and screening instruments for tics and related sensory phenomena.

METHODS: Following the methodology adopted by previous Movement Disorders Society subcommittee papers, a review of severity and screening instruments for tics was completed, applying a classification as "recommended," "suggested," or "listed" to each instrument.

RESULTS: A total of 5 severity scales (Yale Global Tic Severity Scale, Tourette Syndrome Clinical Global Impression, Tourette's Disorder Scale, Shapiro Tourette syndrome Severity Scale, Premonitory Urges for Tics Scale) were "recommended," and 6 (Rush Video-Based Tic Rating Scale, Motor tic, Obsessions and compulsions, Vocal tic Evaluation Survey, Tourette Syndrome Global Scale, Global Tic Rating Scale, Parent Tic Questionnaire, Tourette Syndrome Symptom List) were "suggested." A total of 2 screening instruments (Motor tic, Obsession and compulsions, Vocal tic Evaluation Survey and Autism-Tics, Attention Deficit/Hyperactivity Disorder and Other Comorbidities Inventory) were "recommended," whereas 2 others (Apter 4-questions screening and Proxy Report Questionnaire for Parents and Teachers) were "suggested."

CONCLUSIONS: Our review does not support the need for developing new tic severity or screening instruments. Potential objectives of future research include developing a rating instrument targeting the full spectrum of tic-related abnormal behaviors, assessing/screening malignant forms of tic disorders, and developing patient-reported outcome measures. © 2017 International Parkinson and Movement Disorder Society.


Original languageEnglish
Pages (from-to)467-473
Number of pages7
JournalMovement Disorders
Issue number3
Early online date10 Jan 2017
Publication statusPublished - Mar 2017