COSMIN database

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

Martino, D., Pringsheim, T. M., Cavanna, A. E., Colosimo, C., Hartmann, A., Leckman, J. F., Luo, S., Munchau, A., Goetz, C. G., Stebbins, G. T., and Martinez-Martin, P.
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. (c) 2017 International Parkinson and Movement Disorder Society.
Mov Disord
Publication year:
Symptom status:
Emotional state
Physical state
Adults (18-65)
Children (0-18)
Diseases of and symptoms related to the nervous system
Mental and behavioural disorders and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
6 - Clinical rating scales
7 - Observations