Tics and Tourette syndrome: signs, causes and what helps

A tic is a sudden, rapid, non-rhythmic movement or sound that happens again and again without being intended. Movements are called motor tics and sounds vocal (phonic) tics (WHO, 2024). People with tics are not doing them on purpose and cannot simply stop them (CDC, 2026b). The World Health Organization’s classification lists tic disorders among diseases of the nervous system and also cross-lists them with neurodevelopmental conditions, because the two so often occur together and in the same families (WHO, 2024).

Under the diagnostic criteria, Tourette syndrome means two or more motor tics and at least one vocal tic for a year or more, starting before age 18. When only motor or only vocal tics last a year or more, it is called persistent (chronic) motor or vocal tic disorder, and when tics began less than a year ago, provisional tic disorder (CDC, 2026a). The diagnosis is made from the symptoms and their course; no test confirms it, and tests are done only when other conditions need to be ruled out (Hartmann et al., 2024).

Tics are common in children. In an analysis pooling many studies, tics that pass within a year (formerly called transient tic disorder) were the most common tic disorder, affecting 2.99% of children (Knight et al., 2012). An analysis of 21 population-based studies put Tourette syndrome at about 0.52%, or roughly 3 to 9 in 1,000 children (Scharf et al., 2015). It is 2 to 4 times more common in males than in females (WHO, 2024).

In Korea’s health insurance statistics, the number of people treated mainly for a tic disorder (F95) rose from 16,120 in 2010 to 26,845 in 2025. In 2025, 10- to 19-year-olds were the largest group at 12,829, and 78.2% were male. These are people who were treated, not how many people have tics (Health Insurance Review and Assessment Service, 2026). A study of Korean insurance data on 2- to 19-year-olds found that, on average, 2.6 in 1,000 were treated for a tic disorder each year (Choi et al., 2019).

mind.io does not offer a tic test, and this guide is not a diagnosis. It sets out, from research and official sources, what tics look like, how they change, what causes them, what can look like tics, how to help a child, and the treatments with evidence. ADHD and OCD, which often come with tics, have their own guides: Adult ADHD symptoms and OCD.

Tics are often divided into simple tics, which involve one or a very few muscles, and complex tics, which appear as linked movements of several muscles (National Center for Mental Health, 2020). In early childhood, simple motor tics such as eye blinking, nose wrinkling and facial grimacing, and simple vocal tics such as sniffing, throat clearing and coughing, usually come first (Pringsheim et al., 2021). Vocal tics in the form of phrases, words or sentences are complex tics (National Center for Mental Health, 2020).

Tics often start in the face, with blinking or grimacing, and over time move down to the neck, shoulders, arms and trunk (National Center for Mental Health, 2020). In a study of the records of 119 children treated for tic disorders at one Korean hospital, the most common first tic was eye blinking (50.4%), followed by jaw or lip movements and throat clearing (29.4% each) (Park & Kim, 2021). In Tourette syndrome, vocal tics usually start 1 to 2 years after the motor tics (WHO, 2024).

Many people feel an itch, tightness or rising tension just before a tic, and a brief release afterwards. This is called a premonitory urge. In a survey of 135 people aged 8 to 71 with tic disorders, 93% reported such urges and 84% said a tic brought a feeling of relief (Leckman et al., 1993). Most children only become aware of these urges by about age 10 (WHO, 2024).

Tics can be held back for a short time, but not for long (WHO, 2024). Stress, excitement or tiredness can make them worse (NHS, 2025), and they may lessen during sleep or when someone is absorbed in an activity they enjoy. They wax and wane, sometimes almost disappearing for weeks or months, and old tics can briefly come back when someone is asked about them (WHO, 2024). Tics also often move from one part of the body to another (National Center for Mental Health, 2020).

Involuntary swearing or obscene words (coprolalia) affect only 10 to 15% of people with Tourette syndrome and tend to appear in mid-adolescence (WHO, 2024). Across 15 clinics in seven countries, a study of 597 new patients with Tourette syndrome found that 19.3% of males and 14.6% of females had ever had them (Freeman et al., 2009). Most people with Tourette syndrome never have swearing tics. Tics can cause muscle pain (National Center for Mental Health, 2020), and forceful, frequent tics can cause injury (WHO, 2024).

Tourette syndrome commonly starts between ages 4 and 6, with tics often at their most severe between 8 and 12 (WHO, 2024), and on average tics ease across adolescence. By early adulthood, roughly three in four have much milder tics and more than one in three are tic-free (Bloch & Leckman, 2009). In a study that followed 36 people with Tourette syndrome up to age 18, the worst period came at an average age of 10, and the start of puberty was not linked with the timing or severity of tics (Leckman et al., 1998).

That does not mean tics always vanish. A Danish specialist clinic study saw 314 people aged 5 to 19 and re-examined 227 of them about 6 years later: of those over 16, 17.7% had no tics, 59.5% had minimal or mild tics and 22.8% had moderate or severe tics (Groth et al., 2017). When 39 children with new tics were seen again a year after their first tic, tics had lessened on average, but all still had tics, and only 2 had more than minimal impairment (Kim et al., 2019). French guidelines say symptoms persist into adulthood in about one in three (Hartmann et al., 2024).

Tics that first appear in adulthood are rare and are most often linked with severe stress, certain drugs or an illness affecting the brain, so a doctor should look for the cause (WHO, 2024). In Korea, new diagnoses of tic disorders in adults have risen recently, and in adults the male predominance seen in young people was no longer observed (Kim et al., 2024). In health insurance statistics, the share of people treated for tic disorders who were 20 or older rose from 10.7% in 2010 to 20.7% in 2025 (Health Insurance Review and Assessment Service, 2026). When 31 adults with childhood Tourette syndrome were filmed again, tics had lessened since childhood but 90% still had them, and half of those who thought they were tic-free still showed tics (Pappert et al., 2003).

In children with Tourette syndrome, tics are often not the most lasting or impairing difficulty (Bloch & Leckman, 2009). In a study of 1,374 people with Tourette syndrome, 54.3% had had ADHD and 50.0% OCD at some point in their lives, 36.1% an anxiety disorder and 29.8% a mood disorder; because the participants came from specialist clinics and genetic studies, these rates may be higher than in the general population (Hirschtritt et al., 2015). In Korean insurance data, more than half of 2- to 19-year-olds treated for tic disorders had another mental health condition, and one in three had ADHD (Choi et al., 2019). People with other conditions alongside tics tend to have a poorer course (WHO, 2024), so it matters to look at the whole picture. See also Anxiety symptoms.

Teasing and bullying are a real problem too. In a survey of 211 young people with tic disorders and their parents, 26% reported being bullied by peers most or all of the time. Those who were bullied had more frequent, complex and severe tics, more explosive outbursts, more anxiety and low mood, and a lower quality of life (Zinner et al., 2012).

Tic disorders often run in families, mainly because of genes. A Swedish study of 4,826 people diagnosed with Tourette syndrome or chronic tic disorders and their relatives estimated the heritability of tic disorders at 0.77, placing them among the most heritable neuropsychiatric conditions (Mataix-Cols et al., 2015). Heritability describes where differences within a population come from; it does not mean that a set percentage of one person’s tics is inherited. Research has also consistently linked tics with altered functioning in a brain circuit called the cortico-striato-thalamo-cortical circuit (National Center for Mental Health, 2020).

Tics are not caused by bad parenting. In a survey of 673 Korean adults, people more strongly believed the causes of tics lay in parenting and psychology, and in the brain and body, than in diet or environment (Lee & Park, 2019). Yet tics cluster in families mainly because of genes (Mataix-Cols et al., 2015), and stress, excitement and tiredness are known to make tics worse (WHO, 2024; NHS, 2025). The exact cause is still not known (NHS, 2025).

When a child suddenly develops severe obsessive-compulsive symptoms or tics within days, PANDAS, a proposed syndrome linked to strep infection, or the broader PANS may come up. No lab test can confirm them (NIMH, 2025). A study that followed 715 children with chronic tic disorders from 16 specialist clinics in 9 countries for 16 months on average found that 43% had at least one flare of tics, but no link between strep exposure and flares; the researchers did not recommend strep testing or treatment for tics (Martino et al., 2021). If tics started suddenly and severely, see a paediatrician or child psychiatrist to look into the cause together.

Medicines, drugs or other medical conditions can also cause tics, so these are ruled out when making a diagnosis (WHO, 2024). The link between ADHD medicines and tics is covered in the FAQ below.

From around 2020, tic clinics in several countries saw a sharp rise in young people aged 12 to 25, almost all girls and women, who rapidly developed complex tic-like movements and sounds. Experts regard most of these cases as a functional neurological disorder and call them functional tic-like behaviours. In a registry in Calgary, Canada, all 20 such patients had watched social media influencers with tics or Tourette syndrome (mainly on TikTok), but not every patient at other centres had, so this is not considered a necessary cause (Pringsheim et al., 2021). Six teenage girls reported in the US had all been exposed to a particular social media personality before their symptoms began (Hull & Parnes, 2021).

Unlike tic disorders, which start gradually in childhood with simple tics such as blinking, these symptoms usually begin suddenly in the teens or later, include complex movements and phrases from the start, and in 11 of the 20 patients included repeating swear words or offensive statements. They are harder to hold back, and in these experts’ early experience they did not respond to medicines for tics in the usual way (Pringsheim et al., 2021). Because the two need different treatment, telling them apart matters, and experts have drawn up separate diagnostic criteria (Pringsheim et al., 2023). If such symptoms appear, see a specialist. Suggested approaches include cutting down on tic-related content, managing stress, reducing others’ reactions to the symptoms and treating any anxiety or depression (Pringsheim et al., 2021).

Stereotyped movements in autism are more fixed in form and last longer than a typical tic, start at a younger age, come without a premonitory urge, often feel soothing or enjoyable, and can usually be interrupted by distraction (WHO, 2024). For autism, see Autism in adults. Complex tics and compulsions can be hard to tell apart, but tics are not aimed at cancelling out thoughts such as obsessions or at reducing anxiety. Many people have both, and both diagnoses can be given (WHO, 2024). OCD is covered in OCD.

Many families first take a child who keeps blinking or sniffing to an eye or ear, nose and throat doctor. Checking the eyes and nose is sensible, but if nothing is found and it continues, it may be a tic (National Center for Mental Health, 2020). Tics that first appear in adulthood, start suddenly and severely, or begin after a new medicine, a drug or an illness may have another cause, so see a doctor (WHO, 2024).

Start by learning about tics together and letting your child know it is not their fault. US guidelines recommend educating teachers and classmates about tics (Pringsheim et al., 2019), and European guidelines recommend education about tics as the first step whatever the severity (Andrén et al., 2022).

Pointing out tics, scolding or pressing a child to hold them in does not help (National Center for Mental Health, 2020). Old tics can briefly come back when someone is asked about them (WHO, 2024), and in a study observing two children, vocal tics rose markedly while their tics were being talked about (Woods et al., 2001). So try not to react much to the tics themselves, while giving the child warm attention. For example, avoid “Stop that”, “You’re doing it again”, “Try to hold it in” or “You’re doing it on purpose, aren’t you?”, and say things like “It’s not your fault”, “It’s OK to let it out” or “Tell me if it’s hard”.

A regular daily routine with plenty of physical activity, a calm bedtime routine without phones, and less stress all help (NHS, 2025). But a child should not stop doing what they need to do because of tics (National Center for Mental Health, 2020). Other difficulties often last longer or weigh more than the tics, so helping a child find interests, build friendships and grow in self-esteem matters for adulthood too (Bloch & Leckman, 2009). For stress, see How to relieve stress, and for sleep, Insomnia.

If your child is diagnosed, think about telling the school so it can offer support (NHS, 2025). Explaining tics to classmates can help reduce misunderstanding, unwanted attention and bullying (Tourettes Action, n.d.). You can discuss accommodations with teachers, such as a private place to release tics, short breaks outside the classroom, and a separate room or extra time for tests (Tourette Association of America, n.d.). In Korea, students can also get counselling at their school’s Wee class, which is confidential and free (Korea Policy Briefing, 2022).

Not every tic needs treatment. When tics are not causing physical problems, pain, emotional distress or social embarrassment, learning about tics and watching how they develop is a recommended option, and the American Academy of Neurology advises telling children and families that there is a good chance symptoms will improve in late adolescence (AAN, 2019). When tics get in the way of daily life, behaviour therapy is recommended as the first treatment (AAN, 2019; Andrén et al., 2022).

The behaviour therapy with the most evidence is the Comprehensive Behavioral Intervention for Tics (CBIT), an expanded form of habit reversal training (HRT). It combines education about tics, learning to notice the urge before a tic and to do a different movement that cannot happen at the same time as the tic, relaxation training, and finding and changing situations that make tics worse. Exposure and response prevention (ERP) also has evidence, though with less certainty (Andrén et al., 2022). In habit reversal, for example, when a coughing tic is about to come, a person might close their mouth and breathe slowly through the nose (National Center for Mental Health, 2020). Practising resisting urges in this way has not been found to cause a “rebound” of worse tics afterwards in experimental and therapy studies (Himle & Woods, 2005; Verdellen et al., 2007). But this is practice done with a therapist; it is not a reason to press someone to hold tics in day to day.

In a randomised trial of 126 children aged 9 to 17, 52.5% of those who had 8 sessions of behaviour therapy over 10 weeks were much improved, compared with 18.5% of those who received supportive therapy and education. Among responders who were followed up, 87% still benefited 6 months later (Piacentini et al., 2010). In a trial of 122 adults aged 16 to 69, 38.1% in the behaviour therapy group were much improved, compared with 6.4% in the comparison group (Wilhelm et al., 2012). In the two largest trials, tics fell by 26 to 31%, so it is realistic to expect tics to lessen rather than disappear (Andrén et al., 2022). If seeing a therapist often is hard, behaviour therapy by video call also has evidence (Andrén et al., 2022), and in an English trial of 224 young people aged 9 to 17, online ERP with a little therapist support reduced tics by 16% on average, slightly more than education alone (6%) (Hollis et al., 2021).

When behaviour therapy is not available or not enough and tics seriously disrupt life, medicine may be used, alone or alongside behaviour therapy. Medicines that block dopamine have the most evidence, and when ADHD is also present, alpha-2 agonists may be considered first (Roessner et al., 2022). Alpha-2 agonists had little effect on tics in people without ADHD (Weisman et al., 2013). Medicines do not eliminate tics completely (CDC, 2026b); they need monitoring for side effects such as weight gain, drowsiness and blood pressure changes, and should be tapered slowly with a doctor when stopping (AAN, 2019; Roessner et al., 2022). Treating co-occurring ADHD, OCD, anxiety or depression sometimes reduces tics as well (CDC, 2026b).

Botulinum toxin injections are sometimes considered for older teenagers and adults with a troublesome tic in one area, but the evidence is limited (AAN, 2019). In a small trial that 18 people completed, tics in the treated area became less frequent, but patients did not report an overall benefit (Marras et al., 2001). Deep brain stimulation is an experimental treatment reserved for carefully selected, severely affected people whom other treatments have not helped (Szejko et al., 2022). There is little evidence that complementary treatments help (NHS, 2025).

Depending on age, specialist care is with a psychiatrist or child psychiatrist, or a neurologist or paediatric neurologist (Hartmann et al., 2024). In Korea, local mental health welfare centres and the mental health crisis line 1577-0199 offer counselling and referrals (Ministry of Health and Welfare, 2025), and young people aged 9 to 24 and their parents can use the free 24-hour Youth Counselling 1388 (Korea Policy Briefing, 2024). Elsewhere, Tourettes Action in the UK and the Tourette Association of America offer information for families and schools (Tourettes Action, n.d.; Tourette Association of America, n.d.).

If tics have lasted a long time, or teasing and low mood are wearing someone down, look after their mental health too. A Swedish study comparing 7,736 people treated for tic disorders with people from the general population found higher risks of suicide attempts and of death by suicide, and the risk remained after accounting for other mental health conditions; it was highest when tics persisted beyond young adulthood or there had been a previous suicide attempt (Fernández de la Cruz et al., 2017). If you have thoughts of harming yourself, please reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services.

Q. Is there a self-test for tic disorders? A. mind.io does not offer one. Tic disorders are diagnosed from the symptoms and their course, and no test confirms them (Hartmann et al., 2024). See a doctor if tics cause muscle pain, teasing, low mood or anxiety, or get in the way of school, work or daily life (National Center for Mental Health, 2020).

Q. My child keeps blinking and sniffing. Is it a tic? A. Short-lived tics such as eye blinking or throat clearing are common in childhood (WHO, 2024), and one analysis found that 2.99% of children have tics that pass within a year (Knight et al., 2012). Once eye or nose problems have been checked, watch without commenting. If it lasts more than a year or gets in the way of daily life, see a doctor.

Q. Do tics go away on their own? A. They are usually worst around ages 10 to 12 and ease through adolescence; by early adulthood about three in four have much milder tics and more than one in three are tic-free (Bloch & Leckman, 2009). But mild tics often remain in adults (Pappert et al., 2003), and in about one in three, symptoms continue into adulthood (Hartmann et al., 2024).

Q. I am an adult and have started having tics. Can adult tics be treated? A. Tics that first start in adulthood are rare, so a doctor should check for other causes (WHO, 2024). For tics that have continued since childhood, behaviour therapy has worked in adults too (Wilhelm et al., 2012).

Q. Do people with Tourette syndrome swear? A. Most do not. Swearing tics affect only 10 to 15% of people with Tourette syndrome (WHO, 2024). If swearing and complex movements start suddenly together in the teens or later, with no tics in early childhood, they may be functional tic-like behaviours, so see a doctor (Pringsheim et al., 2021).

Q. Can watching TikTok or YouTube videos cause tics? A. The link with tic-related videos has been reported mainly for functional tic-like behaviours that start suddenly in the teens or later, and even then not everyone had watched such videos (Pringsheim et al., 2021). If this sounds familiar, cut down on tic-related content and see a doctor. Ways to cut down screen use are in Smartphone addiction.

Q. Do ADHD medicines cause or worsen tics? A. In an analysis of 22 placebo-controlled trials (2,385 children with ADHD), new or worse tics were reported in 5.7% on stimulants and 6.5% on placebo (Cohen et al., 2015). Still, tics may get worse in individual cases (Osland et al., 2018), so if you are worried, talk to the prescriber rather than stopping the medicine on your own.

Q. My child’s tics got worse after a sore throat. Is it PANDAS? A. Tics naturally wax and wane (WHO, 2024). In a study of 715 children with chronic tic disorders, strep exposure was not linked with tic flares (Martino et al., 2021). But if severe obsessive-compulsive symptoms or tics appeared suddenly within days, see a doctor (NIMH, 2025).

Q. My child is teased about tics and says they want to die. A. Stay with your child and listen to them. Reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If they are in immediate danger, contact your local emergency services. Deal with the bullying together with the school.

References: World Health Organization (2024), Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (CDDR), https://www.who.int/publications/i/item/9789240077263; Centers for Disease Control and Prevention (2026a), Diagnosing Tourette syndrome, https://www.cdc.gov/tourette-syndrome/diagnosis/index.html; Centers for Disease Control and Prevention (2026b), Treatment of Tourette syndrome, https://www.cdc.gov/tourette-syndrome/treatment/index.html; Hartmann, A., Ansquer, S., Brefel-Courbon, C., Burbaud, P., Castrioto, A., Czernecki, V., et al. (2024), French guidelines for the diagnosis and management of Tourette syndrome, Revue Neurologique, 180(8), 818-827, https://doi.org/10.1016/j.neurol.2024.04.005; Health Insurance Review and Assessment Service (2026), Disease statistics: F95 tic disorders, 2010-2025 [in Korean], https://opendata.hira.or.kr; Knight, T., Steeves, T., Day, L., Lowerison, M., Jette, N., & Pringsheim, T. (2012), Prevalence of tic disorders: A systematic review and meta-analysis, Pediatric Neurology, 47(2), 77-90, https://doi.org/10.1016/j.pediatrneurol.2012.05.002; Scharf, J. M., Miller, L. L., Gauvin, C. A., Alabiso, J., Mathews, C. A., & Ben-Shlomo, Y. (2015), Population prevalence of Tourette syndrome: A systematic review and meta-analysis, Movement Disorders, 30(2), 221-228, https://doi.org/10.1002/mds.26089; Choi, S., Lee, H., Song, D. H., & Cheon, K. A. (2019), Population-based epidemiology of pediatric patients with treated tic disorders from real-world evidence in Korea, Journal of Child and Adolescent Psychopharmacology, 29(10), 764-772, https://doi.org/10.1089/cap.2019.0050; National Center for Mental Health (2020), Tic disorders [National Mental Health Information Portal, in Korean], https://www.mentalhealth.go.kr/portal/disease/diseaseDetail.do?dissId=13; Pringsheim, T., Ganos, C., McGuire, J. F., Hedderly, T., Woods, D., Gilbert, D. L., et al. (2021), Rapid onset functional tic-like behaviors in young females during the COVID-19 pandemic, Movement Disorders, 36(12), 2707-2713, https://doi.org/10.1002/mds.28778; Park, E. G., & Kim, Y. H. (2021), Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: A retrospective chart review study from South Korea, BMC Psychiatry, 21(1), 14, https://doi.org/10.1186/s12888-020-03014-z; Leckman, J. F., Walker, D. E., & Cohen, D. J. (1993), Premonitory urges in Tourette’s syndrome, American Journal of Psychiatry, 150(1), 98-102, https://doi.org/10.1176/ajp.150.1.98; NHS (2025), Tourette syndrome, https://www.nhs.uk/conditions/tourettes-syndrome/; Freeman, R. D., Zinner, S. H., Müller-Vahl, K. R., Fast, D. K., Burd, L. J., Kano, Y., et al. (2009), Coprophenomena in Tourette syndrome, Developmental Medicine & Child Neurology, 51(3), 218-227, https://doi.org/10.1111/j.1469-8749.2008.03135.x; Bloch, M. H., & Leckman, J. F. (2009), Clinical course of Tourette syndrome, Journal of Psychosomatic Research, 67(6), 497-501, https://doi.org/10.1016/j.jpsychores.2009.09.002; Leckman, J. F., Zhang, H., Vitale, A., Lahnin, F., Lynch, K., Bondi, C., et al. (1998), Course of tic severity in Tourette syndrome: The first two decades, Pediatrics, 102(1), 14-19, https://doi.org/10.1542/peds.102.1.14; Groth, C., Mol Debes, N., Rask, C. U., Lange, T., & Skov, L. (2017), Course of Tourette syndrome and comorbidities in a large prospective clinical study, Journal of the American Academy of Child & Adolescent Psychiatry, 56(4), 304-312, https://doi.org/10.1016/j.jaac.2017.01.010; Kim, S., Greene, D. J., Bihun, E. C., Koller, J. M., Hampton, J. M., Acevedo, H., et al. (2019), Provisional tic disorder is not so transient, Scientific Reports, 9(1), 3951, https://doi.org/10.1038/s41598-019-40133-4; Kim, S., Kim, M. S., Kim, J., & Hong, S. B. (2024), Incidence trend and epidemiology of tic disorders among youths and adults in Korea from 2003 to 2020: A national population-based study, Psychiatry Research, 331, 115634, https://doi.org/10.1016/j.psychres.2023.115634; Pappert, E. J., Goetz, C. G., Louis, E. D., Blasucci, L., & Leurgans, S. (2003), Objective assessments of longitudinal outcome in Gilles de la Tourette’s syndrome, Neurology, 61(7), 936-940, https://doi.org/10.1212/01.wnl.0000086370.10186.7c; Hirschtritt, M. E., Lee, P. C., Pauls, D. L., Dion, Y., Grados, M. A., Illmann, C., et al. (2015), Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome, JAMA Psychiatry, 72(4), 325-333, https://doi.org/10.1001/jamapsychiatry.2014.2650; Zinner, S. H., Conelea, C. A., Glew, G. M., Woods, D. W., & Budman, C. L. (2012), Peer victimization in youth with Tourette syndrome and other chronic tic disorders, Child Psychiatry & Human Development, 43(1), 124-136, https://doi.org/10.1007/s10578-011-0249-y; Mataix-Cols, D., Isomura, K., Pérez-Vigil, A., Chang, Z., Rück, C., Larsson, K. J., et al. (2015), Familial risks of Tourette syndrome and chronic tic disorders: A population-based cohort study, JAMA Psychiatry, 72(8), 787-793, https://doi.org/10.1001/jamapsychiatry.2015.0627; Lee, M., & Park, S. (2019), Beliefs about tic disorders and Tourette’s syndrome in South Korea: An online panel survey, Journal of the Korean Academy of Child and Adolescent Psychiatry, 30(3), 109-115, https://doi.org/10.5765/jkacap.190007; National Institute of Mental Health (2025), PANS and PANDAS: Questions and answers, https://www.nimh.nih.gov/health/publications/pandas; Martino, D., Schrag, A., Anastasiou, Z., Apter, A., Benaroya-Milstein, N., Buttiglione, M., et al. (2021), Association of group A Streptococcus exposure and exacerbations of chronic tic disorders: A multinational prospective cohort study, Neurology, 96(12), e1680-e1693, https://doi.org/10.1212/WNL.0000000000011610; Hull, M., & Parnes, M. (2021), Tics and TikTok: Functional tics spread through social media, Movement Disorders Clinical Practice, 8(8), 1248-1252, https://doi.org/10.1002/mdc3.13267; Pringsheim, T., Ganos, C., Nilles, C., Cavanna, A. E., Gilbert, D. L., Greenberg, E., et al. (2023), European Society for the Study of Tourette Syndrome 2022 criteria for clinical diagnosis of functional tic-like behaviours: International consensus from experts in tic disorders, European Journal of Neurology, 30(4), 902-910, https://doi.org/10.1111/ene.15672; Pringsheim, T., Okun, M. S., Müller-Vahl, K., Martino, D., Jankovic, J., Cavanna, A. E., et al. (2019), Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders, Neurology, 92(19), 896-906, https://doi.org/10.1212/WNL.0000000000007466; Andrén, P., Jakubovski, E., Murphy, T. L., Woitecki, K., Tarnok, Z., Zimmerman-Brenner, S., et al. (2022), European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part II: psychological interventions, European Child & Adolescent Psychiatry, 31(3), 403-423, https://doi.org/10.1007/s00787-021-01845-z; Woods, D. W., Watson, T. S., Wolfe, E., Twohig, M. P., & Friman, P. C. (2001), Analyzing the influence of tic-related talk on vocal and motor tics in children with Tourette’s syndrome, Journal of Applied Behavior Analysis, 34(3), 353-356, https://doi.org/10.1901/jaba.2001.34-353; National Center of Neurology and Psychiatry (n.d.), Developmental disorders (neurodevelopmental disorders) [Kokoro no joho site, in Japanese], https://kokoro.ncnp.go.jp/disease.php?@uid=MbkmLbVbTEhSpxyE; Tourettes Action (n.d.), Education: information for parent/carers and students, https://www.tourettes-action.org.uk/76-education--information-for-parentcarers-and-students.html; Tourette Association of America (n.d.), Classroom strategies and techniques, https://tourette.org/resources/overview/tools-for-educators/classroom-strategies-techniques/; Korea Policy Briefing (2022), Strength to stand up again for students in crisis: the Wee project [in Korean], https://www.korea.kr/news/policyNewsView.do?newsId=148909192; AFSGT (n.d.), Association Française du Syndrome de Gilles de La Tourette, https://www.france-tourette.org/; American Academy of Neurology (AAN) (2019), New AAN guideline for treating Tourette syndrome and other chronic tic disorders [press release, 6 May 2019], https://www.aan.com/PressRoom/Home/PressRelease/2721; Himle, M. B., & Woods, D. W. (2005), An experimental evaluation of tic suppression and the tic rebound effect, Behaviour Research and Therapy, 43(11), 1443-1451, https://doi.org/10.1016/j.brat.2004.11.002; Verdellen, C. W., Hoogduin, C. A., & Keijsers, G. P. (2007), Tic suppression in the treatment of Tourette’s syndrome with exposure therapy: The rebound phenomenon reconsidered, Movement Disorders, 22(11), 1601-1606, https://doi.org/10.1002/mds.21577; Piacentini, J., Woods, D. W., Scahill, L., Wilhelm, S., Peterson, A. L., Chang, S., et al. (2010), Behavior therapy for children with Tourette disorder: A randomized controlled trial, JAMA, 303(19), 1929-1937, https://doi.org/10.1001/jama.2010.607; Wilhelm, S., Peterson, A. L., Piacentini, J., Woods, D. W., Deckersbach, T., Sukhodolsky, D. G., et al. (2012), Randomized trial of behavior therapy for adults with Tourette syndrome, Archives of General Psychiatry, 69(8), 795-803, https://doi.org/10.1001/archgenpsychiatry.2011.1528; Hollis, C., Hall, C. L., Jones, R., Marston, L., Le Novere, M., Hunter, R., et al. (2021), Therapist-supported online remote behavioural intervention for tics in children and adolescents in England (ORBIT): A multicentre, parallel group, single-blind, randomised controlled trial, The Lancet Psychiatry, 8(10), 871-882, https://doi.org/10.1016/S2215-0366(21)00235-2; Roessner, V., Eichele, H., Stern, J. S., Skov, L., Rizzo, R., Debes, N. M., et al. (2022), European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment, European Child & Adolescent Psychiatry, 31(3), 425-441, https://doi.org/10.1007/s00787-021-01899-z; Weisman, H., Qureshi, I. A., Leckman, J. F., Scahill, L., & Bloch, M. H. (2013), Systematic review: Pharmacological treatment of tic disorders—efficacy of antipsychotic and alpha-2 adrenergic agonist agents, Neuroscience & Biobehavioral Reviews, 37(6), 1162-1171, https://doi.org/10.1016/j.neubiorev.2012.09.008; Marras, C., Andrews, D., Sime, E., & Lang, A. E. (2001), Botulinum toxin for simple motor tics: A randomized, double-blind, controlled clinical trial, Neurology, 56(5), 605-610, https://doi.org/10.1212/wnl.56.5.605; Szejko, N., Worbe, Y., Hartmann, A., Visser-Vandewalle, V., Ackermans, L., Ganos, C., et al. (2022), European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part IV: deep brain stimulation, European Child & Adolescent Psychiatry, 31(3), 443-461, https://doi.org/10.1007/s00787-021-01881-9; Santé.fr (2026), Syndrome Gilles de La Tourette : des tics indomptables, https://www.sante.fr/node/20103641; Ministry of Health and Welfare (2025), Community mental health welfare centres and the mental health crisis line [in Korean], https://www.mohw.go.kr/menu.es?mid=a10706040100; Korea Policy Briefing (2024), Youth Counselling 1388, open 365 days a year, 24 hours a day [in Korean], https://www.korea.kr/news/policyNewsView.do?newsId=148937356; Korean Tourette Association (n.d.), Korean Tourette Association blog [in Korean], https://kotsa33.tistory.com/; Fernández de la Cruz, L., Rydell, M., Runeson, B., Brander, G., Rück, C., D’Onofrio, B. M., et al. (2017), Suicide in Tourette’s and chronic tic disorders, Biological Psychiatry, 82(2), 111-118, https://doi.org/10.1016/j.biopsych.2016.08.023; Cohen, S. C., Mulqueen, J. M., Ferracioli-Oda, E., Stuckelman, Z. D., Coughlin, C. G., Leckman, J. F., et al. (2015), Meta-analysis: Risk of tics associated with psychostimulant use in randomized, placebo-controlled trials, Journal of the American Academy of Child & Adolescent Psychiatry, 54(9), 728-736, https://doi.org/10.1016/j.jaac.2015.06.011; Osland, S. T., Steeves, T. D., & Pringsheim, T. (2018), Pharmacological treatment for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders, Cochrane Database of Systematic Reviews, 6, CD007990, https://doi.org/10.1002/14651858.CD007990.pub3