Objective In Tourette syndrome (TS), multiple motor and vocal tics are frequently accompanied by complex tics with social significance, including imitation (echophenomena), and urges to perform socially inappropriate behaviours. Furthermore, previous studies have highlighted differences in the way individuals with TS reason about social and emotional information. In this study we explored whether TS may be characterised by differences in the tendency to adopt alternative perspectives and to relate emotionally to others in everyday life.

Method We administered the Interpersonal Reactivity Index to a total of 155 adults, of whom 95 had TS and the remainder were healthy controls. Between-group comparisons were conducted separately for males and females, and within-group analyses explored whether any clinical features (tics, premonitory urges, symptoms of common co-morbid disorders) were linked to scale ratings.

Results Both males and females with TS were found to exhibit a different Interpersonal Reactivity Profile to healthy gender-matched controls, which consisted of a reduced tendency to take the perspective of others, and elevated personal distress when faced with other people in crises. There were no group differences for the fantasy or empathic concern subscales. Personal distress ratings were strongly associated with tic severity and weakly related to attention problems.

Conclusion The pattern of interpersonal reactivity ratings suggests that an elevated distress response to witnessing highly emotive situations may encourage a defensive strategy of reduced perspective taking in TS. These findings provide further evidence that TS is associated with changes in social cognition, as reflected in patients' self-reported everyday behaviour.