JOURNAL of PSYCHOPATHOLOGY Editorial 2019;25:179-182
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Understanding Tourette Syndrome and Its Effects on Learning
Understanding Tourette Syndrome And Its Effects On Learning Tourette Association Education In-Service A Teacher’s Perspective I’ve come to the conclusion that I am the decisive element in the classroom. It’s my personal approach that creates the climate. It’s my daily mood that makes the weather. As a teacher, I possess a tremendous power to make a child’s life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or honor, hurt or heal. In all situations, it is my response that decides whether a crisis will be escalated or de-escalated and a child humanized or de-humanized. – Haim Ginott 2 Learning Objectives At the end of this presentation, you will be able to do the following: 1. List the characteristics of TS. 2. Identify the most common disorders and difficulties associated with TS. 3. Discuss the impact of these disorders on classroom performance. 4. Identify classroom strategies and techniques for working with children with TS. 3 Tourette Syndrome (TS) • Neurodevelopmental disorder • Genetic • Not rare • Motor and vocal tics (involuntary movements and sounds) • Due to the nature of TS, symptoms will vary from person to person 4 How Common are TS and Tic Disorders • TS is classified as one of several neurodevelopmental conditions referred to as tic disorders. • 1 in every 160 school-aged children (0.6%) in the United States has Tourette Syndrome. • 1 in every 100 school-aged children (1%) in the United States has Tourette Syndrome or another tic disorder. • Tic disorders occur more frequently in boys than girls. -
Sensory Gating Scales and Premonitory Urges in Tourette Syndrome
Short Communication TheScientificWorldJOURNAL (2011) 11, 736–741 ISSN 1537-744X; DOI 10.1100/tsw.2011.57 Sensory Gating Scales and Premonitory Urges in Tourette Syndrome Ashley N. Sutherland Owens1, Euripedes C. Miguel2, and Neal R. Swerdlow1,* 1Department of Psychiatry, UCSD School of Medicine, La Jolla, CA; 2Departamento de Psiquiatria da Faculdade de Medicina da USP, Sao Paulo, SP, Brazil E-mail: [email protected] Received June 17, 2010; Revised January 28, 2011, Accepted February 7, 2011; Published March 22, 2011 Sensory and sensorimotor gating deficits characterize both Tourette syndrome (TS) and schizophrenia. Premonitory urges (PU) in TS can be assessed with the University of Sao Paulo Sensory Phenomena Scale (USP-SPS) and the Premonitory Urge for Tics Scale (PUTS). In 40 subjects (TS: n = 18; healthy comparison subjects [HCS]: n = 22), we examined the relationship between PU scores and measures of sensory gating using the USP-SPS, PUTS, Sensory Gating Inventory (SGI), and Structured Interview for Assessing Perceptual Anomalies (SIAPA), as well symptom severity scales. SGI, but not SIAPA, scores were elevated in TS subjects (p < 0.0003). In TS subjects, USP-SPS and PUTS scores correlated significantly with each other, but not with the SGI or SIAPA; neither PU nor sensory gating scales correlated significantly with symptom severity. TS subjects endorse difficulties in sensory gating and the SGI may be valuable for studying these clinical phenomena. KEYWORDS: premonitory urge, sensory gating, tic, Tourette syndrome INTRODUCTION Tourette syndrome (TS) is one of several brain disorders characterized by symptoms that suggest failures in the automatic ―gating‖ of sensory stimuli. In TS, intrusive sensory information is often experienced as pressure or discomfort, at or below the skin level, or as a mental sensation[1]. -
Siondróm Tourette
CUID 1: Siondróim Mheasúnaithe 15 Siondróm Tourette I Have Tourettes, but Tourettes Doesn’t Have Me Teideal ar chlár faisnéise HBO a craoladh ar 11 Nollaig 2005, atá liostaithe ar http://tsa-usa.org/ Caithfidh tic gutha (torainn) amháin nó níos mó agus il-ticeanna luaile (preaba) a bheith ann ar feadh bliana ar a laghad chun diagnóis de shiondróm Tourette a chinntiú. Tá seans go mbeidh na ticeanna seo ann ag an am céanna nó ag amanna difriúla agus go dtiocfaidh athruithe ar cé chomh minic agus ar cé chomh dian agus a bheidh siad. Go hiondúil, tosaíonn na hairíonna sula sroicheann an duine bliain is fiche. Tosaíonn an siondróm ag seacht mbliana d'aois ar an meán. Tá bunús bithcheimicieach le siondróm Tourette agus tarchuirtear é go géiniteach. Is féidir le ticeanna luaile nó gutha a bheith simplí nó casta. Tá ticeanna simplí luaile a bhaineann leis an gceann agus an aghaidh, m.sh. caochadh na súl, fiarshúilí, rollú na súl, preaba na sróine, preaba béil, déanamh aghaidheanna, gobadh na teanga, bogadh nó claonadh an chinn go cliathánach. Ansin tá ticeanna simplí eile a bhaineann leis an gcorp m.sh. bogadh suas agus síos na guaillí, leathnú agus sracadh géag, ciceáil cos agus sracadh glún, agus crapadh boilg, is é sin, tarraingíonn an duine an bolg isteach. Tá ticeanna casta luaile ann freisin, m.sh. bolú agus líochán rudaí, caitheamh seilí, teagmháil le codanna dá gcorp féin agus le coirp daoine eile, agus geáitsí neamhghnácha cosúil le casadh, gogaireacht, truslóg a thabhairt, agus cromadh síos. Tá ticeanna simplí gutha ann m.sh. -
Tourette's Syndrome
Tourette’s Syndrome CHRISTOPHER KENNEY, MD; SHENG-HAN KUO, MD; and JOOHI JIMENEZ-SHAHED, MD Baylor College of Medicine, Houston, Texas Tourette’s syndrome is a movement disorder most commonly seen in school-age children. The incidence peaks around preadolescence with one half of cases resolving in early adult- hood. Tourette’s syndrome is the most common cause of tics, which are involuntary or semi- voluntary, sudden, brief, intermittent, repetitive movements (motor tics) or sounds (phonic tics). It is often associated with psychiatric comorbidities, mainly attention-deficit/hyperac- tivity disorder and obsessive-compulsive disorder. Given its diverse presentation, Tourette’s syndrome can mimic many hyperkinetic disorders, making the diagnosis challenging at times. The etiology of this syndrome is thought to be related to basal ganglia dysfunction. Treatment can be behavioral, pharmacologic, or surgical, and is dictated by the most incapacitating symp- toms. Alpha2-adrenergic agonists are the first line of pharmacologic therapy, but dopamine- receptor–blocking drugs are required for multiple, complex tics. Dopamine-receptor–blocking drugs are associated with potential side effects including sedation, weight gain, acute dystonic reactions, and tardive dyskinesia. Appropriate diagnosis and treatment can substantially improve quality of life and psychosocial functioning in affected children. (Am Fam Physician. 2008;77(5):651-658, 659-660. Copyright © 2008 American Academy of Family Physicians.) ▲ Patient information: n 1885, Georges Gilles de la Tourette normal context or in inappropriate situa- A handout on Tourette’s described the major clinical features tions, thus calling attention to the person syndrome, written by the authors of this article, is of the syndrome that now carries his because of their exaggerated, forceful, and provided on p. -
The Use of Deep Brain Stimulation in Tourette's Syndrome
Neurosurg Focus 35 (5):E4, 2013 ©AANS, 2013 The use of deep brain stimulation in Tourette’s syndrome JANINE ROTSIDES, B.S., AND ANTONIOS MAmmIS, M.D. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey Tourette’s syndrome (TS) is a childhood neuropsychiatric disorder characterized by multiple involuntary motor and vocal tics. It is commonly associated with other behavioral disorders including attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, anxiety, depression, and self-injurious behaviors. Tourette’s syndrome can be effectively managed with psychobehavioral and pharmacological treatments, and many patients experience an improvement in tics in adulthood. However, symptoms may persist and cause severe impairment in a small subset of patients despite available therapies. In recent years, deep brain stimulation (DBS) has been shown to be a promising treatment option for such patients. Since the advent of its use in 1999, multiple targets have been identified in DBS for TS, including the medial thalamus, globus pallidus internus, globus pallidus externus, anterior limb of the internal capsule/nucleus accumbens, and subthalamic nucleus. While the medial thalamus is the most commonly reported trajectory, the optimal surgical target for TS is still a topic of much debate. This paper provides a review of the avail- able literature regarding the use of DBS for TS. (http://thejns.org/doi/abs/10.3171/2013.8.FOCUS13292) KEY WORDS • Tourette’s syndrome • tics • deep brain stimulation • medial thalamus • globus pallidus N 1885, Georges Gilles de la Tourette described 9 pa- cade of life, with a mean age of onset of 7 years. Initial tients who suffered from “a neurological condition symptoms commonly manifest as simple motor tics of characterized by motor incoordination accompanied the head and face, with vocal tics appearing 1–2 years byI echolalia and coprolalia.”30 Charcot later named the later. -
Tourette Syndrome
Tourette Syndrome What is Tourette Syndrome? Tourette Syndrome (TS), or Tourette’s Disorder is a childhood neuropsychiatric (mental and nervous system) disorder that involves multiple tics—repetitive sudden movements (motor tics) and vocal outbursts (phonic tics) that seem largely outside of the person’s control. TS is one kind of a spectrum of tic disorders that includes transient tics (tics of less than a year’s duration) and chronic tics (tics typically lasting more than a year.) TS affects each person differently. However, tics tend to occur many times each day (often in flurries), typically wax and wane in their severity, change in form over time, and may disappear for weeks or months before coming back. What are tics like? Tics vary greatly and can be very confusing. TS symptoms tend to emerge between five and eighteen years of age and often stop by early adulthood. They are often divided into four varieties: • Simple motor - These tics are sudden, quick movements that involve a limited number of muscles and are usually repetitive. Examples: eye blinking, grimacing, shoulder shrugging and head jerking. • Simple phonic - These tics are when sounds are made. Examples: throat clearing, coughing, yelping or sniffing. • Complex motor – Movements that last longer and seem more purposeful. Examples: smelling things, jumping, touching or hitting others and self-injurious behaviors. • Complex phonic - Tics involve repeating sounds or phrases nonsensically. Examples: emitting words or phrases out of context, counting things out loud, or more rarely, vocalizing socially unacceptable words. What other disorders are associated with TS? While many people only have tics, it is not unusual for people with TS to have other disorders (i.e. -
Challenges in Managing Treatment-Refractory Obsessive-Compulsive Disorder and Tourette’S Syndrome Paulo Lizano, MD, Phd, Ami Popat-Jain, MA, Jeremiah M
CLINICAL CHALLENGE Editor: Joji Suzuki, MD Challenges in Managing Treatment-Refractory Obsessive-Compulsive Disorder and Tourette’s Syndrome Paulo Lizano, MD, PhD, Ami Popat-Jain, MA, Jeremiah M. Scharf, MD, PhD, Noah C. Berman, PhD, Alik Widge, MD, PhD, Darin D. Dougherty, MD, MMSc, and Emad Eskandar, MD, MBA Keywords: cognitive-behavioral therapy, deep brain stimulation, exposure response prevention, memantine, obsessive-compulsive disorder, Tourtette’s syndrome CASE HISTORY to our PHP and, because of his outbursts, forced to live in Mr. R was a 19-year-old, single, unemployed, homeless His- the associated shelter. On admission, he endorsed his mood panic male with a history of Tourette’s syndrome (TS), obsessive- as “sad.” He admitted to having tics (vocalizations, moving compulsive disorder (OCD), attention-deficit/hyperactivity foot, head, scratching) and OCD symptoms (looking at things disorder (ADHD), and posttraumatic stress disorder. In ad- a certain number of times, obsession with symmetry, and star- dition, he suffered from suicidal ideation, self-injurious ing at a corner) that lasted the whole day. He endorsed anxi- behavior (superficial cutting and head banging), anxiety, de- ety that consisted of general worry and ruminations about the pression, and anger outbursts. He was referred to our cognitive- past. He denied any manic or psychotic symptoms, as well as behavioral therapy (CBT) partial hospitalization program (PHP) suicidal or homicidal ideation. and associated homeless shelter for the targeted treatment of his Developmentally, the patient was born at 40 weeks gesta- OCD, TS, and anger outbursts after being discharged from tion,birthweight8lbs,2oz,anddeliveredbynormalspontane- a psychiatric hospital. ous vaginal delivery, with no prenatal or perinatal complications. -
Síndrome Gilles Tourette: Revisión Teórica
UNIVERSIDAD NACIONAL AUTÓNOMA DE MÉXICO FACULTAD DE PSICOLOGÍA DIVISIÓN DE ESTUDIOS PROFESIONALES SÍNDROME DE GILLES DE LA TOURETTE: UNA REVISIÓN TEÓRICA TESIS QUE PARA OBTENER EL TÍTULO DE LICENCIADO EN PSICOLOGÍA PRESENTA OMAR ORTEGA NORIEGA DIRECTOR: LIC. AIDA ARACELI MENDOZA IBARROLA REVISOR: LIC. ANA EUGENIA DÍAZ DE LEON D’ HERS. CIUDAD UNIVERSITARIA, D.F. MARZO 2013 UNAM – Dirección General de Bibliotecas Tesis Digitales Restricciones de uso DERECHOS RESERVADOS © PROHIBIDA SU REPRODUCCIÓN TOTAL O PARCIAL Todo el material contenido en esta tesis esta protegido por la Ley Federal del Derecho de Autor (LFDA) de los Estados Unidos Mexicanos (México). El uso de imágenes, fragmentos de videos, y demás material que sea objeto de protección de los derechos de autor, será exclusivamente para fines educativos e informativos y deberá citar la fuente donde la obtuvo mencionando el autor o autores. Cualquier uso distinto como el lucro, reproducción, edición o modificación, será perseguido y sancionado por el respectivo titular de los Derechos de Autor. Agradecimientos A Dios: Todo viene de ti y todo es para ti, gracias. A las maestras Ana Eugenia y Martha , son un regalo para la UNAM. A mi familia: Gracias por ser esos ángeles que me apoyan en todo. A Jani Esmeralda: Gracias por ser el amor de mi vida. A mis amigos: porque es un privilegio el poder estar a su lado. INDICE Resumen Introducción 1. Antecedentes históricos ............................................................................. 1 2. Descripción – Definición ............................................................................ -
Chlorpromazine-Induced Relapse of Tourette Syndrome in a Patient with Intellectual Disability, Attention Deficit Hyperactivity Disorder, and Schizophrenia
Open Access Case Report DOI: 10.7759/cureus.10732 Chlorpromazine-Induced Relapse of Tourette Syndrome in a Patient With Intellectual Disability, Attention Deficit Hyperactivity Disorder, and Schizophrenia Anum Maqsood 1 , Salman Akram 2 , Faisal Akram 3 1. Internal Medicine, Howard University Hospital, Washington, DC, USA 2. Internal Medicine, Rawalpindi Medical University, Gujranwala, PAK 3. Psychiatry, Department of Behavioral Health, Saint Elizabeths Hospital, Washington, DC, USA Corresponding author: Anum Maqsood, [email protected] Abstract Tourette syndrome (TS) is a chronic neuropsychiatric disorder characterized by recurrent multiple motor and vocal tics that last for at least one year and follow a waxing and waning course. A fundamental step in the pathophysiology of TS is the hyperactivity of dopaminergic system leading to increased dopamine release in the cortical-basal ganglia-thalamo-cortical (CBGTC) circuits, thereby providing the rationale for treatment with dopamine receptor, in particular D2, antagonists. Although antipsychotics have shown considerable efficacy against tics in most patients, there have been cases of paradoxical onset of tics in individuals without history, and relapse or exacerbation of tics in individuals with a history of tic disorders upon initiation of antipsychotics. Here we report a case of an individual with intellectual disability, attention deficit hyperactivity disorder (ADHD), and schizophrenia, who experienced a relapse of TS symptoms after initiation of chlorpromazine therapy. Categories: Neurology, Psychiatry Keywords: tourette syndrome, chlorpromazine, attention deficit hyperactivity disorder, schizophrenia Introduction Tourette syndrome (TS) is a neuropsychiatric disorder characterized by childhood onset of chronic motor and vocal tics with “a waxing and waning” course [1,2]. It is a lifelong disorder with the most severe symptoms occurring between 8 and 12 years, usually followed by a gradual decline in severity [3]. -
Tourette Syndrome and Tic Disorders
Tourette Syndrome and Tic Disorders Presentation by Kiran Singh, PGY-3 UCI/CHOC Pediatrics Residency Program Case 1: Leslie ● 8 year old previously healthy female. At age 6, she started developing involuntary blinking and head jerking. These movements will sometimes recede for a couple of weeks but then reappear without any known triggers. She has a family history of generalized anxiety disorder in mom, OCD in dad. She is not on any medications currently. Otherwise, she is doing well in school, and has been told she has “above average intelligence. Mom does, however, report that she has “an anxious temperament.” What is her diagnosis? Case 2: Benjamin ● 11 year old with history of inattention and hyperactivity presenting with a history of throat clearing since age 10, with grimacing and shoulder shrugging. Mom is frustrated with his behavior, saying “first he wouldn’t stop disrupting class by clearing his throat loudly, which finally got better over the last few weeks, but now he’s starting to make grunting sounds!” Benjamin says he can’t control these actions, that he just has an urge to them and feels better after doing them. He otherwise is not on any medications. His brother has a history of ADHD. What is his diagnosis? Tic Disorders: DSM V diagnoses ● Tourette’s disorder: the presence of both motor and vocal tics for more than 1 year (Case 2: Benjamin) ● Persistent (chronic) motor or vocal tic disorder: single or multiple motor or vocal tics for more than 1 year, but not both motor and vocal (Case 1: Leslie) ● Provisional tic disorder -
Assimilation of Alters in a Case of Dissociative Identity Disorder
MIAMI UNIVERSITY The Graduate School Certificate for Approving the Dissertation We hereby approve the Dissertation of Carol Lee Bentall Humphreys Candidate for the Degree: Doctor of Philosophy _______________________ Chair William B. Stiles, Ph.D. ____________________________ Reader Roger M. Knudson, Ph.D. _____________________________ Reader Larry M. Leitner, Ph.D. _____________________________ Graduate School Representative Paul V. Anderson, Ph.D. ABSTRACT FROM FRAGMENTATION TO NEGOTIATION: ASSIMILATION OF ALTERS IN A CASE OF DISSOCIATIVE IDENTITY DISORDER By Carol Lee Bentall Humphreys This case study examined the psychological changes shown by Kristen, a female client diagnosed with Dissociative Identity Disorder, across four years of psychotherapy. A team of eight (six coinvestigators, myself as the primary investigator and former therapist, as well as my dissertation advisor) tracked Kristen and her alters’ shift in experience from internal fragmentation at therapy intake to dramatically increased communication among her alters at termination. This change process included the gradual reduction of Kristen’s internal amnesic barriers as she actively engaged in therapy. Her experience of “pulling one brick out at a time” was examined using the assimilation model, a theory of psychological change. We analyzed therapy notes, psychological reports, audio-tapes, video-tapes, transcribed therapy sessions, client-produced emails, drawings, and letters to further an understanding as to how change occurs in therapy for those who experience -
Key Facts for Teachers -Action Tourettes
Neither rewards nor punishment will enable a student to control tics. However, there may be things which make Resources Tourette Syndrome it easier for tics to be minimised and this can usually be Tourettes Action can provide information and discovered in discussion with the student and their family. PowerPoint presentations for schools. It may be possible for us to offer some whole school training. KEY FACTS FOR Try not to respond too much to tics as this can normalise them. However, often tics are humorous and it would be Please note that this leaflet is designed to offer unnatural not to recognise this. support to teachers in classroom settings and explain TEACHERS how Tourette Syndrome affects students. TS is not caused by bad parenting or abuse. When children are able to suppress their tics at school this may well lead It does not cover the legal requirements surrounding to increased tics and behaviours at home. It does not the implementation of the disabilities discrimination act, mean that school is OK and something is wrong at home. the new code of practice or obtaining an EHC plan. Home is a safe place to let all your tics out. However, this does mean that often homework is especially hard. It may be helpful to provide time and space for tics to be let out in private, thus lessening the build-up of tension. Perhaps a ‘time out’ card would allow the Contact us student to go to the designated place without causing too much disruption if it becomes unbearable for them. Call our Helpdesk to speak to us between 9am and 5pm, Monday to Friday on 0300 777 8427 Try to avoid seating arrangements where tics will cause the greatest disruption, for example the middle of rows or near something breakable.