ArticleBMJ open2026
Stigma and risk of self-injury and suicidality in adults with Tourette syndrome: findings from a cross-sectional impact survey.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdults with Tourette syndrome (ATS) face increased risks of self-injury behaviours (SIBs) and suicidality, yet research has largely focused on biological factors. Despite stigma being a known contributor to these outcomes in marginalised groups, its role in ATS remains unexplored. This study aims to address this gap by examining the impact of stigma on SIBs and suicidality in ATS.
methodsThis study analysed adult data from the Tourette Association of America's 2022 Impact Survey, conducted online via convenience sampling. Stigma was assessed via six items, generating scores ranging from 1.0 to 4.0, with higher scores indicating greater stigma. The outcomes included lifetime self-harm, past-year suicidal ideation and suicide attempts. Owing to missing data, a Heckman selection model with a probit link function was used to examine the relationships between stigma and these outcomes, adjusting for demographic and clinical factors.
resultsThe study included 601 US ATS, with moderate to high stigma levels. Among the participants, 58% reported lifetime self-harm, 43% had past-year suicidal ideation and 27% had attempted suicide at least once in the past year. The Heckman selection model confirmed a significant association between stigma and all three outcomes.
conclusionsThis sample of ATS, on average, endures medium-high levels of stigma, which significantly contributes to their risk of self-injury, suicidal ideation and suicidal behaviours. Given this heightened risk, it is crucial to integrate stigma reduction interventions into health and mental health services for this vulnerable population.
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