Talk:Tourette syndrome

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Possessive or not?

So is the official term Tourette or Tourette's? I seem to remember reading that 'Down' syndrome is now preferred over 'Down's.' The page title is Tourette, but the article uses Tourette's as well. If a decision has been made in the field to replace the possessive, then the article should be consistent with that practice. MarkinBoston (talk) 23:02, 17 November 2011 (UTC)

Different names different places-- the DSM calls it Tourette's disorder, most research calls it Tourette syndrome, the most official organizations are Tourette syndrome, and in Europe it's more commonly Gilles de la Tourette disorder. So, as laid out in the first line-- many names. The article name is the most common since there is discrepancy, and the text uses both in deference to the many different names used in the literature. SandyGeorgia (Talk) 14:46, 18 November 2011 (UTC)

Frequencies of tics and Tourette's

The lead says: Between 1 and 10 children per 1,000 have Tourette's; as many as 10 per 1,000 people may have tic disorders,. Tourette's is the graver section of the tic disorders. The less grave tic problems are more common. In light of this the range of probable frequency of tic disorders should be higher than the range for Tourette's. But here they are said to have the same upper bound. At least one part must be wrong. But I am new to this. --Ettrig (talk) 18:43, 21 December 2011 (UTC)

First, your statement is wrong (perhaps I'm misunderstanding), and second, the first statement applies to children, the other to people (that is, not only children). Besides, I've got four new secondary reviews sitting on my desktop that I plan to use for an update in the New Year, after the holidays, so those numbers may change anyway (although I doubt it, since these numbers are most likely still correct). SandyGeorgia (Talk) 18:48, 21 December 2011 (UTC)

I missed the distinction between children and adults. Maybe unnecessarily complex to have those in the same sentence. Putting them in the same sentence is a signal that they are comparable. --Ettrig (talk) 20:39, 21 December 2011 (UTC)

They are comparable (prevalence in children, prevalence in all people including adults): you seem to be the first person to have missed this in six years. I would recommend that you suggest alternate wording, but it would seem to be a waste of time until I've read and incorporated the four new review articles that I'm planning to add after Christmas, since the text may change anyway. SandyGeorgia (Talk) 21:20, 21 December 2011 (UTC)

New reviews

• Bloch M, State M, Pittenger C. "Recent advances in Tourette syndrome". Curr. Opin. Neurol. 2011 Apr;24(2):119–25. doi:10.1097/WCO.0b013e328344648c PMID 21386676
• Du JC, Chiu TF, Lee KM, et al. "Tourette syndrome in children: an updated review". Pediatr Neonatol. 2010 Oct;51(5):255–64. doi:10.1016/S1875-9572(10)60050-2 PMID 20951354
• Singer HS. "Tourette syndrome and other tic disorders". Handb Clin Neurol. 2011;100:641–57. doi:10.1016/B978-0-444-52014-2.00046-X PMID 21496613
• Robertson MM. "Gilles de la Tourette syndrome: the complexities of phenotype and treatment". Br J Hosp Med (Lond). 2011 Feb;72(2):100–7. PMID 21378617

For after the holidays, SandyGeorgia (Talk) 20:00, 21 December 2011 (UTC)

Okey dokey. Barring any other major kerfuffles on the Wikipedia which drain my editing time, I'm ready to get started here. I've decided not to work in sandbox and that the best way for me to proceed is with a printout and a good old fashioned red marker-- trying to update so many citations in edit mode with Wiki markup will be a surefire way to get lost and waste a lot of time. So, with a printout in hand, I plan to address most of the first pass citation update offline with a red marker, do most of the citation updating in a few edits, and also add a few new tidbits that surfaced in the new sources. Little of substance has changed (one source even mentions that TS hasn't received the kind of research support other neuropsychiatric conditions have), but I'd still rather have the most recent review sources listed in place of some 2000 or 2004 sources. Once I'm done updating the citations and adding the few new tidbits, I'd like to reinforce the lead (which IMO has been weakened over time), and then I'll request others to help smooth out the prose. It may take me several days to rejig all the citations-- perhaps not there til after the New Year. SandyGeorgia (Talk) 15:58, 29 December 2011 (UTC)

Lead

Moved comorbid to the lead, due to its importance in prognosis, diagnosis and treatment, moved notable individuals out to make room, and will tackle epidemiology in the lead last, since it first needs to be sorted out in the body of the article (that is, incorporating new data from new reviews). So, done moving old sources out of the lead for now, new sources in, will review all citation formatting once I'm done, please comment on lead text now if so desired, or wait til I'm done even better :) Once I've finished, there will probably be another sentence on research directions and other new tidbits ... for now, I just wanted to demote the old sources and get the newer ones up front. SandyGeorgia (Talk) 20:12, 29 December 2011 (UTC)

Most finished rejigging citations,[1] now need to rewrite some portions that depended too heavily on older sources, and add some new text. SandyGeorgia (Talk) 11:52, 30 December 2011 (UTC)

Next

All that fuss, urgency and kerfuffle just when we should have been enjoying Christmas, and now nothing? Grand. Anyway, next I plan to specifically update PANDAS and epidemiology to the new reviews, then add some new research directions, and after that, I'll begin an overall text review to rewrite some sections using the new sources. SandyGeorgia (Talk) 18:00, 30 December 2011 (UTC)

Epidemiology

Big mess to sort out, since each one of them is reporting from a different perspective. Some discuss TS, while others include all tic disorder, some discuss children, while others include broader population (adults included). Some discuss special ed populations. Ack.

We are currently reporting in the article

• up to 1% of people having tic disorders (that's all people, adults included, and all tic disorders) based on Scahill, and
• .1 to 1% of children having Tourette's (based on Lombroso Scahill) and a tighter emerging consensus of .6 to .8% of children having TS based on Scahill.

New reviews (based largely on the same ole studies reported by Scahill) say different things, but a lot of it is apples and oranges, depending on what they're reporting:

Bloch 2009

Once thought to be a rare condition, TS is known to affect four to six in every 1000 children. Transient tic disorder, characterized by tics that are present for less than a year in duration, and chronic tic disorders, which are characterized by either motor or vocal tics, but not both, have a lifetime prevalence of approximately 20% and 5%, respectively, in children.

Bloch 2011

The prevalence of Tourette syndrome is estimated at between 0.3 and 1%. However, the epidemiological literature is limited, and characterizations of the natural history tend to reflect a strong ascertainment bias. Many individuals with vocal and/or motor tics do not seek medical attention. The vast majority who do also suffer from other neuropsychiatric symptoms. Upwards of 50% of Tourette syndrome probands seen in clinical settings have attention deficit hyperactivity disorder (ADHD) or obsessive–compulsive disorder. Learning disabilities, mood and anxiety disorders are also quite common. In fact, these comorbid conditions often dominate the clinical picture, and their occurrence along with tics, rather than tics in isolation, can present the most pressing challenges for clinical management.

Singer 2011

The prevalence (number of cases in population at a given time) of TS varies widely in published reports, ranging from 5/10 000 (Apter et al., 1993) to 299/10 000 (Mason et al., 1998). Nevertheless, the estimated plausible prevalence of impairing cases is 1/1000 individuals and the prevalence of milder forms of TS may approach 0.6% of the general population.

Swain 2007

Prevalence rates of TS and related conditions vary according to the source, age, and sex of the sample; the ascertainment procedures; and diagnostic system. Once considered an extremely rare disorder, current estimates of the prevalence of TS are approximately 4 to 6/1,000 children in European and Asian populations. By contrast, simple and transient tics are quite common, affecting up to 6% to 20% of all children.

Du 2010

... the disorder affects 1−3% of Western ... school-aged children. ... Transient tic disorder, manifested by tics that are present for less than 1 year, affects approximately 6−20% of children in lifetime prevalence. Chronic tic disorders, which are characterized by either motor or vocal tics, but not both, occur in 5% of school-aged children.

Robertson 2008

Caveat-- I'm always suspicious of Robertson reviews, as they ever so frequently report on her "opinion", which isn't always an opinion shared by her peers. FWIW. ... remarkably consistent findings, demonstrating prevalence figures for GTS of between 0.4% and 3.8% for youngsters between the ages of 5 and 18 years.

Robertson 2011

Tourette syndrome was once considered to be uncommon, but studies have suggested a prevalence of 1% of youngsters between the ages of 5 and 18 years. ... The majority of the Tourette syndrome ‘cases’ identified were undiagnosed and mild, without distress, impairment or coprolalia. The prevalence of Tourette syndrome in special educational populations, such as those with emotional and behavioural and/or learning difficulties or autistic spectrum disorders, is higher. Robertson (2008) suggests that although less obvious or severe, the prevalence in adults is also 1%.

(Her "Robertson suggests" kind of wording in a review written by her is typical of her writing and what concerns me-- how about independent collaboration of her suggestions and conclusions? I can't find anyone else supporting her conclusion that TS is also present in 1% of adults, although I don't necessarily dispute it-- it makes sense-- the tics may diminish as children pass through adolescence, but they still have TS.) Besides, how does she go from .4-3.8 in her 2008 paper to calling it 1% in her 2011 quote of same? This is the same kind of mess we got into last time we tried to sort prevlance-- epidemiology in TS is a mess because of all of the factors affecting the studies (explained in the article), so I tend to trust Scahill/Bloch/Yale and Singer/Johns Hopkins more. SandyGeorgia (Talk) 21:40, 30 December 2011 (UTC)

So ...

I hope this covers it:

According to Scahill et al. (2006), up to 1% of the population experiences tic disorders, including chronic tics and transient tics in childhood. Robertson (2011) suggests that the prevalence of Tourette syndrome alone in the general population is also 1%, with a range reported between .4% and 3.8% for children ages 5 to 18. Singer (2011) states the prevalence of TS in the overall population at any time is .1% for impairing cases and .6% for all cases, while Bloch et al. (2011) state the overall prevalence as between .3 and 1%. According to Lombroso and Scahill (2008), the emerging consensus is that .1 to 1% of children have Tourette's, with several studies supporting a tighter range of .6 to .8%; Swain (2007) and Bloch (2009) report a range of prevalence in children of .4 to .6%, while Du et al. (2010) report that 1 to 3% of Western school-age children have Tourette's. Bloch (2009) says that chronic tics affect 5% of children, and transient tics affect 20%. Prevalence rates in special education populations are higher.

SandyGeorgia (Talk) 22:34, 30 December 2011 (UTC)

Actually, I'm thinking of leaving Du out, since it's an outlier and the distinction of Western will only confuse (likely better diagnosis in Western countries, or some such thing). If no one weighs in, I'm going to add this. SandyGeorgia (Talk) 23:13, 30 December 2011 (UTC)

Re your "talking to myself" edit summary. I'm watching but busy with family stuff and waiting for those reviews to arrive in the mail :-). I think the above notes are very useful for arranging one's thoughts and working out exactly what to put into the article per WEIGHT and judgement. They may also prove useful later if figures are challenged because it will be easier to find the figures used and the figures not used. Colin°^Talk 10:56, 31 December 2011 (UTC)

A quick glance at your summary paragraph: The text has "chronic tics and transient tics" stats sandwiching the "tourette syndrome" stats. Would it help to separate those or at least group them together? One can work out from these stats that tic disorders are much much more common in children than the general population, but the text doesn't make that flow out naturally. The final "prevalence rates in special education populations" comment is not clear whether it refers to TS prevalence or tic disorders -- but if it comes from Robertson 2011 then it must be the former. It would become clear if it were in a paragraph or body of text that only discussed TS prevalence. Colin°^Talk 10:56, 31 December 2011 (UTC)

Thanks, Colin-- I wasn't sure anyone else was still on board :) I will work on your comments above, and revisiting the sources, I've decided I should add the Du stats, which are not likely outliers, but a reflection of better knowledge in Western countries. On it later today. SandyGeorgia (Talk) 16:00, 31 December 2011 (UTC)

Comments

• Tourette's is associated with several comorbid conditions, or co-occurring diagnoses, which are often the major source of impairment for an affected child. Why do we need to say the same thing twice here? Are we teaching terminology? Is this normal for Wikipedia? --Ettrig (talk) 20:20, 21 December 2011 (UTC)

• Yes, it is common to not require readers to "click out" to a link to understand the term-- it is frequently asked for at FAC, and it was repeatedly asked for in the development of this particular article. Not everyone knows the meaning of "comorbid", and it is not good practice to require readers to click to get a definition. SandyGeorgia (Talk) 21:18, 21 December 2011 (UTC)

See WP:NOT PAPERS (policy) point 7. One of my favourite policy statements. Colin°^Talk 21:43, 21 December 2011 (UTC)

Your comments are surely based on a misreading of my comment. Please try again. --Ettrig (talk) 22:18, 21 December 2011 (UTC)

Ettrig, I think you're actually the one misreading here - as Sandy explains, "co-occuring diagnoses" is an explanatory gloss of "comorbid conditions", and in fact explaining terminology in that way is encouraged to increase accessibility. Nikkimaria (talk) 05:31, 22 December 2011 (UTC)

My suggestion is to remove "comorbid conditions or,. We seem to agree that those words are a potential problem. To me, co-occurring diagnosis is fine. Why not just remove the problem? --Ettrig (talk) 08:49, 22 December 2011 (UTC)

In other words, you want us to leave off "comorbid condition", which is the correct technical medical scientific term and Wiki article, used in every source and commonly understood by everyone well versed in neuropsychiatric disorders, rather than include a few words to clarify the term for the layreaders who might not know the term? And would you like us to do the same on every FA-- that is, dumb then down? For that we have the Simple Wikipedia-- here, on FAs, as good practice, we clarify terms as appropriate for layreaders so that the article is accurate but they don't have to click out. This is a groaner, you pretent to make broad statements and recommendations about FAs (like running the dismal Saturn on the mainpage and even claiming it was in good shape). Having to answer things like this to someone who doesn't seem to know WP:WIAFA or common writing conventions on Wikipedia is not the way I want to spend my Christmas. If you had ever written an FA, you would understand that, and I wouldn't find myself spending time during the holidays explaining same and being quite ready to walk away from this place rather than spend my fifth Christmas dealing with craziness. SandyGeorgia (Talk) 16:27, 22 December 2011 (UTC)

Most of the above (from This is a groaner ...) is argumentation of a kind that is not to occur in Wikipedia. You don't need to take it from me that comorbid condition is problematic. By explaining it the article shows that the writers understand that it needs to be explained. I accept your statement that it is the correct technical medical scientific term, in many sources and understood by people well versed in the field. In effect you characterize this phrase as technical jargon. That characterization is not a valid argument for using it in Wikipedia. Wikipedia articles are not to read like the scientific sources and we are not to assume technical expertise. Writing without technical jargon is a difficult but valuable service to the readers. It should not be characterized as dumbing down. Using terms that needs to be explained in every paragraph creates an unnecessarily complex text. Also, it isn't consistently explained in this article. To avoid technical jargon is not at all the same ambition as that of Simple Wikipedia. --Ettrig (talk) 19:20, 22 December 2011 (UTC)

In the guideline Wikipedia:Make technical articles understandable, it does not say "never use jargon". You won't find a strong promoter than me of efforts to make our medical articles understandable to the general reader. We can often avoid jargon, particularly when the word is not subsequently used by the article and isn't key to understanding the literature in the field. However we are here to educate readers and sometimes that education involves learning new words. The word "comorbid" is used twenty times in this article and three times in the titles of our sources. Unlike some medical conditions, the comorbid aspects of TS are quite significant and frequently discussed by the literature, so this word is one we need to educate our readers about. We wikilink the word on its first use and also explain it "(co-occurring diagnoses other than Tourette's)" on first use too. Because this is a long article, it is also wikilinked and explained later on too. Since the lead should be especially easy to read, we don't use the word there at all. This is best-practice wrt dealing with a technical term. Colin°^Talk 20:01, 22 December 2011 (UTC)

What about simply saying ".. comorbid (co-occurring) conditions"? And if the word is used twenty times in the article (I didn't count..), why not do this on the first occurrence - like the standard policy for only the first occurrence of a term being linked. 98.223.232.121 (talk) 21:50, 25 December 2011 (UTC)Jim

The notion that we should define a medical term that is central to understanding of the condition, its prognosis, treatment, and diagnosis on the first occurrence of that term is brilliant! Why didn't I, or other FAC reviewers, think of that? Oh, we did. Here is the version that was featured in October 2006, where the first occurrence of comorbid (in an article that uses that term 26 times) is defined (and has been since October 2006). Please, opine all you want, but read the article first.

Now, I have four new sources to incorporate, and I would find it much easier to complete the overhaul I was intending to this article long before I moved, was under construction, and had a funeral if I could finish incorporating the new sources before I have to answer prose questions on the FAC that was so well reviewed that it still holds the record for total number of unanimous supports-- this article was not poorly reviewed, but it is ready for an overhaul of sources, then some prose smoothing after new info is added, and I will not enjoy working under someone else's timeline and having my holiday disrupted. SandyGeorgia (Talk) 16:43, 28 December 2011 (UTC)

Having questions about the current prose is not necessarily a bad thing -- because it can highlight areas of confusion or where improvement can be made. However, the various criticisms here seem to be especially ignorant of both the subject and the actual article text. Sandy, I suggest you just place any future issues raised on-hold until after reworking. Colin°^Talk 16:51, 28 December 2011 (UTC)

I agree that prose questions can help illuminate areas of the text that might need better clarification, but the problem we're having here is that we have people opining who don't appear to have read the text, resulting in a timesink. I'd like to think I can update the sources and add a few new tidbits of info I've found without having to simultaneously smooth prose, since for the way I work, that will be better done after I've updated. Perhaps if I work in sandbox I can work in peace ... not sure ... but the appearance of Ettrig and two IPs here, following on the TCO debacle, is interesting, and makes me wonder what the motivation is. Methinks that people who are genuinely informed and interested in Wikipedia's best work will at least have read the article. SandyGeorgia (Talk) 16:55, 28 December 2011 (UTC)

• I find it peculiar that there are Notable people ... in all walks of life. Is there no walk of life with only ordinary people? People with Tourette's have been noted in all walks of life. (?) --Ettrig (talk) 20:45, 21 December 2011 (UTC)

• Feel free to suggest alternate wording, if the colloquialism troubles you-- it hasn't troubled anyone previously.

• (1) I had already done that. (2) Neither of us know how many found this faulty. The vast majority of readers do not comment. --Ettrig (talk) 21:36, 21 December 2011 (UTC)

Yes, this was my lack of understanding of everyday English. --Ettrig (talk) 08:49, 22 December 2011 (UTC)

Please take care to discuss your edits before making them so you won't introduce unsourced original research (See WP:OWN#Featured articles). Also, nitpicking numbers in the next few weeks will be a rather large waste of everyone's time, since I will be incorporating four new review articles after Christmas. SandyGeorgia (Talk) 21:18, 21 December 2011 (UTC)

• The emerging consensus is that 1–10 children per 1,000 have Tourette's, with several studies supporting a tighter range of 6–8 children per 1,000. Using year 2000 census data, a prevalence range of 1–10 per 1,000 yields an estimate of 53,000–530,000 school-age children with Tourette's in the US. Here we are saying that the true number is anywhere between 1 and 10. That is, we have very low accuracy. Yet this low accuracy is described with the precision of two figures. This breaches the norm that the precision of a statement should be adapted to the accuracy of the statement. Here we have a precision that is three orders of magnitude finer than the accuracy. --Ettrig (talk) 21:32, 21 December 2011 (UTC)

• The precision comes from the source; we don't make it up (that would be original research). At any rate, the emerging consensus of 1 to 10 may now be tighter. Would you notice if I again asked you not to concern yourself with numbers that may change when I incorporate new reviews next week or the next (depending on how much of my time you waste this week)? SandyGeorgia (Talk) 21:40, 21 December 2011 (UTC)

• The relation between accuracy and precision is basic/fundamental. This is what I learnt in what you would call High School physics and later was repeated in the first lecture in metrology. It is not reasonable that I should need to explain this. But you are a very special person on Wikipedia, so I will spend the time that is needed. --Ettrig (talk) 21:49, 21 December 2011 (UTC)

• "1-10 per 1,000" is repeated in consequtive sentences. --Ettrig (talk) 21:32, 21 December 2011 (UTC)
• Some people believe that there may be latent advantages associated with genetic vulnerability to the syndrome. One cannot be vulnerable to a syndrome. --Ettrig (talk) 21:49, 21 December 2011 (UTC)

One can indeed be genetically vulnerable to a syndrome... Check out "Genetic vulnerability factors have been implicated in the vertical transmission of TS and related disorders" [2] Doc James (talk · contribs · email) 22:12, 21 December 2011 (UTC)

I, too, am having a hard time seeing what Ettrig doesn't understand about that statement (one most certainly can be genetically vulnerable to a syndrome, and that is about the most common wording ever, seen in almost every source that discusses TS). Without knowing why Ettrig disclaims this fact, I'm unsure how to make it more clear to him. The article already discusses that TS is thought to involve an interplay between epigenetic factors and an underlying genetic vulnerability. SandyGeorgia (Talk) 00:20, 22 December 2011 (UTC)

I understand it. But the formulation is incorrect. The problem is failure to make the distinction between disorder and syndrome. Tourette´s is both a syndrome and a disorder. So it is natural to sometimes forget that TS literally means the syndrome rather than the disorder. It is clear from the quote that the disorder was intended. A syndrome is a set of signs or symptoms. One is not vulnerable to the signs, one is vulnerable to the disorder that causes the signs. I suggest syndrome is changed to disorder. --Ettrig (talk) 08:49, 22 December 2011 (UTC)

While I respect the point you intend to be making, this is somewhat disingenous since most people refer to the disorder by one of its alternate names which includes syndrome, and I believe in this context that is abundantly clear, particulary since the name of the article is Tourette syndrome. At any rate, the very author who wrote that cited text (Kathryn Taubert in the Leckman/Cohen book) would be offended by changing it to disorder, so as soon as I get a moment, I will review her exact words and suggest alternate wording to address your concern. SandyGeorgia (Talk) 16:18, 22 December 2011 (UTC)

Medicine is not that finely parsed. Mental diseases are not technically diseases per the original definition of a disease but we and the rest of society still refer to them as such.Doc James (talk · contribs · email) 17:02, 28 December 2011 (UTC)

I've reexamined the sources, and there are more/better things that can be said there, so I'll be reworking that part anyway. SandyGeorgia (Talk) 17:04, 28 December 2011 (UTC)

Revised wording, please comment-- much more can be said, but in the interest of keeping the article length reasonable, I stopped there. SandyGeorgia (Talk) 21:31, 29 December 2011 (UTC)

• I could not access Note 5, Portraits of adults with TS. Tourette Syndrome Association. Retrieved on January 4, 2007.--Ettrig (talk) 22:09, 21 December 2011 (UTC)

• I will check that next (the TSA changes their website URLs every time they get a new volunteer to work on it, which is a supreme pain in the neck, so I usually link only to archive.org for them).

  I've now skimmed the four (new) sources above, and each of them states prevalence in a different way (some for children, some lifetime, some for special ed, some for severe vs mild cases, etc), so when it comes to updating the article, we're going to have an apples and oranges issue to sort out, but the numbers now in the article are still broadly correct. At any rate, will get to sorting this after the holidays as part of a global update, and tweaking the wording that is currently in the article is not a productive use of time.

  On the precision issue, sorry, when reliable sources report numbers, we report them, we don't do the math ourselves (that is original research), and I went well beyond high school physics, so unless you have a particular reason for honing in on this article, I'd appreciate a break having just been relatively absent from Wikipedia for several weeks due to a funeral, and I don't plan to do the global update to reflect the newer reviews on Christmas. Is there any particular reason for your urgency on this article? Because I hope you don't plan on sending it to TFAR per your particularly strange views that only articles like this one should be eligible to be Featured Articles,[3] [4] since I also have to travel cross country for a significant family birthday in January, and don't have any intention of having to defend this article from mainpage vandalism while attending an 80th birthday party. SandyGeorgia (Talk) 23:41, 21 December 2011 (UTC)

• OK, I have temporarily updated the dead TSA links, but that was a waste of time considering I'm planning an overhaul of this article, and several of the links I updated are of issues covered in the new reviews. SandyGeorgia (Talk) 00:18, 22 December 2011 (UTC)

There are so many facets to this. (1) Yes, I think this article should be TFA as soon as possible. (2) This is my way of following your advice that articles should be made TFA ready before TFA. I see now that that will take considerable time. So no stress. (3) Yes, I do think there should be a higher requirement of notability for FA eligibility than for inclusion in Wikipedia. This is only one aspect of what I think is a basic issue: The number of page views is an important indicator of how much a Wikipedia article is worth for the readers and for the Wikipedia project. (4) In this context Tourette's is a superstar with 133,000 downloads in November. The threshold of 200,000 articles that I suggested in one of the links would be at around 5000 pageviews in a month and would make for example Cadillac Cimarron eligible. --Ettrig (talk) 08:49, 22 December 2011 (UTC)

On 1), we are fortunate that Raul and Dabomb both defer to significant contributor wishes, and since I'm the only person with all the sources at hand, I'm grateful they've never been prone to running this on the mainpage while I'm traveling. On 2), nothing to do with making it TFA ready-- I've spent the last year moving and under construction, then got my hands on four new reviews recently, then spent the last few weeks dealing with a funeral. A global update is overdue here, and working on it over Christmas has me, well ... unpleased. Certain people lately are making Wikipedia so much not fun it's no longer worth being here. 3) Fortunately, you are so far off on that notion that it's a non-starter, unless the goal is to chase so many editors off of Wikipedia that the entire notion of FAs becomes meaningless as we recruit students who add non-policy compliant tidbits to replace the experienced FA writers we're losing. Merry Christmas; now, if you want to nitpick, everyone's time will be better spent after I do the global update. SandyGeorgia (Talk) 16:15, 22 December 2011 (UTC)

Ettrig, this article has been subject to some careful review wrt figures. The editor Eubulides worked on this with Sandy a while back (Eubulides is no longer with us, to WP's great loss). We might wish for them to be cleaner but we have to live with what the sources say. It is always good for an editor to come along with fresh eyes and point out areas they don't understand or that look wrong -- because that might be an opportunity to improve the wording or update with new material. On a large featured article, it is impossible to keep the sources and their various facts at one's fingertips. Since Sandy is planning to rework some of this with new review sources, it would be useful if you would continue to point out problematic areas on the talk page but then please be patient over the holidays while we all have real-life things to attend to. Cheers, Colin°^Talk 08:55, 22 December 2011 (UTC)

Edit request

may not always be correctly identified -> may not always be correctly diagnosed — Preceding unsigned comment added by 220.241.144.250 (talk • contribs) 13:37, December 23, 2011‎

Y Done.-gadfium 20:12, 23 December 2011 (UTC)

I reverted this edit because it's completely wrong. When <folks> go into the field to make estimates in broad-based populations of the prevalence of medical conditions, they are not always "diagnosing"-- they are "identifying". SandyGeorgia (Talk) 16:31, 28 December 2011 (UTC)

Disagree. How does this concept of identification (as opposed to diagnosis) apply to this sentence about Tourette's? 220.241.144.250 (talk) 13:16, 14 January 2012 (UTC)

The sentence is: "Tourette's is no longer considered a rare condition, but it is not always correctly identified because most cases are mild and the severity of tics decreases for most children as they pass through adolescence." The sentence is about epidemiology, not diagnosis. It is true that it is not always correctly diagnosed-- more broadly, in epidemiological studies, neither it is always correctly identified, for a number of reasons explained in the article and summarized in the lead. SandyGeorgia (Talk) 20:24, 14 January 2012 (UTC)

OK, thanks. 220.241.144.250 (talk) 13:36, 16 January 2012 (UTC)

Edit request on 26 February 2012

Pediatric acute-onset neuropsychiatric syndrome (PANS) is a syndrome in which children have abrupt, dramatic onset of Tourette's Syndrome, obsessive-compulsive disorder (OCD), or anorexia nervosa coincident with the presence of two or more neuropsychiatric symptoms. It is believed that these children experience a rise in dopamine levels as a result of a of cross-reactive anti-neuronal antibodies triggered by streptococcal or mycoplasma infection. The cross-reaction is believed to cause such side effects as tics.

Werelived (talk) 02:48, 26 February 2012 (UTC)

No. 1. You are misreading the source. Tics are hypothetically a feature of PANS, but you've extended that to TS, which misses the whole point of the PANS hypothesis. PANS is hypothetically posed as a condition in which symptoms are not better explained by another condition such as Tourette's, so your text is wrong. Second, there is exactly one paper written about PANS, it is a proposal, see WP:RECENTISM, and there is no reason to include speculative text in a Featured article. If more papers are published, and if PANS gains some widespread medical consensus, and if secondary reviews discuss it, then you might propose accurate text here discussing the situation. I'm a bit concerned that you are editing both PANDAS and PANS, and yet your definition of the hypothetical PANS above does not seem to match the cited source, which discusses abrupt onset of OCD. Furthermore, PANS is proposed for research purposes-- until there is more coverage, it doesn't belong in this (an unrelated) article. SandyGeorgia (Talk) 03:13, 26 February 2012 (UTC)

Not done: please establish a consensus for this alteration before using the {{edit semi-protected}} template. See above. elektrikSHOOS (talk) 05:26, 26 February 2012 (UTC)