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Tourette’s Syndrome and OCD

Tourette's Syndrome is a Mental Illness That is Often Associated with OCD

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Updated August 23, 2010

Tourette’s syndrome is named after French neurologist Georges Gilles de la Tourette who first described this disorder in 1885. This childhood-onset movement disorder is often associated with obsessive-compulsive disorder (OCD), attention-deficit disorder (ADHD), and other behavioral problems.

What Are the Symptoms of Tourette’s Syndrome?

The main symptom associated with Tourette’s syndrome is the presence of tics. Tics are sudden, brief, involuntary or semi-voluntary movements or sounds.

Motor Tics

  • Simple motor tics involve only a single muscle or group of muscles and can be brief (eye-blinking or nose twitching), prolonged (shoulder turning or mouth opening) or sustained for a long period of time (extending or flexing a limb).

  • Complex motor tics are more involved and often resemble normal movement such as jumping, hitting, throwing or touching; however, they often occur in inappropriate settings or include inappropriate or obscene gestures. These complex motor tics can cause considerable embarrassment for affected person.

Sound or Phonic Tics

  • Simple phonic tics are usually meaningless noises or utterances. Common examples include blowing, coughing, throat clearing, grunting, sniffing or hiccuping.

  • Complex phonic tics comprise words or phrases that include obscenities, echoing what others say, and repeating one’s own statements.

Tics can be suppressed and usually improve when the child is distracted; however, they can reappear anytime. Suppressing tics for a long period of time can actually lead to a dramatic increase in tics later on.

Many patients report physical discomfort just before carrying out a tic. Affected children will execute the tic over and over again until it feels “just right.”

Who Gets Tourette’s Syndrome?

Tourette’s syndrome is relatively rare, occurring in less than 1% of the population. It is five times more common among males than females and usually begins between 8 and 10 years of age. For most children, symptoms tend to improve by the end of adolescence with a small number becoming symptom free.

Many children with Tourette’s also have ADHD, OCD and other psychiatric problems, such as depression or social phobia. Other behavioral problems common to children with Tourette’s syndrome are poor impulse control, inability to control anger, inappropriate sexual aggressiveness and antisocial behavior.

What Causes Tourette’s Syndrome?

As tics and associated illnesses like OCD improve with medications that alter the serotonin and dopamine systems, it has been speculated that Tourette’s syndrome may be partially the result of dysregulation of these neurochemicals.

In addition, many studies have noted abnormalities within an area of the brain called the basal ganglia (an area important to the initiation and cessation of movement) among people with Tourette’s syndrome.

Genes may also play a role in developing Tourette’s syndrome. Close relatives of individuals with Tourette’s syndrome often have tics, OCD or ADHD.

How Is Tourette’s Syndrome Treated?

Behavioral treatments that aim to improve social functioning, self-esteem and quality of life are the first-line treatment strategy for Tourette’s syndrome. Common behavior therapies employed include cognitive-behavior therapy and relaxation therapy. Engagement of parents, teachers and classmates in the efforts is often essential for effective treatment.

If the child is severely affected or engaging in self-harming behavior, then medical treatment can be helpful. Medications that are effective for treating the symptoms of Tourette’s syndrome include atypical antipsychotics, such as Haldol (Haloperidol) and Pimozide (Pimozide), and atypical antipsychotics, such as Risperdal (Risperidone) and Zyprexa (Olanzapine).

When symptoms of OCD, anxiety and depression are present, treatment may also include antidepressant medications, such as Prozac (Fluoxetine) or Anafranil (Clomipramine). Be sure to discuss which treatment options may be best with your family doctor.

Source:

Jankovic, J. “Tourette’s Syndrome” The New England Journal of Medicine 2001 345: 1184-1192.

Kenney, C., Kuo, S.H., & Jimenez-Shahed, J. “Tourette’s Syndrome” American Family Physician 2008 77: 651-658.

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