Managing Tourette & Tic Disorders
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Inositol Safety: Clinical Evidences
European Review for Medical and Pharmacological Sciences 2011; 15: 931-936 Inositol safety: clinical evidences G. CARLOMAGNO, V. UNFER AGUNCO Obstetrics & Gynecology Center, Rome (Italy) Abstract. – Myo-inositol is a six carbon ent required by the human cells for the growth cyclitol that contains five equatorial and one axi- and survival in the culture. In humans and other al hydroxyl groups. Myo-inositol has been classi- species, Myo-inositol can be converted to either fied as an insulin sensitizing agent and it is L- or D-chiro-inositol by epimerases. Early stud- commonly used in the treatment of the Polycys- tic Ovary Syndrome (PCOS). However, despite ies showed that inositol urinary clearance was al- its wide clinical use, there is still scarce informa- tered in type 2 diabetes patients, the next step tion on the myo-inositol safety and/or side ef- was to link impaired inositol clearance with in- fects. The aim of the present review was to sum- sulin resistance (for a review see1). Because of marize and discuss available data on the myo-in- these properties, inositol have been classified as ositol safety both in non-clinical and clinical set- “insulin sensitizing agent”2. tings. The main outcome was that only the highest In the recent years, inositol has found more dose of myo-inositol (12 g/day) induced mild and more space in the reproductive clinical prac- gastrointestinal side effects such as nausea, fla- tice3-6. Indeed, since the main therapy for Poly- tus and diarrhea. The severity of side effects did cystic Ovary Syndrome (PCOS) is the use of in- not increase with the dosage. -
Icelandic Primary Care Physicians' Perceived
ICELANDIC PRIMARY CARE PHYSICIANS’ PERCEIVED COMPETENCE IN DETECTION AND TREATMENT OF BEHAVIOR DISORDERS Haukur Sigurðsson A Thesis Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS August 2007 Committee: William H. O’Brien, Advisor Robert A. Carels Michael J. Zickar © 2006 Haukur Sigurðsson All Rights Reserved iii ABSTRACT William H. O’Brien, Advisor While mental disorders are prevalent in primary health care settings, they often go undetected and untreated. There are no records to be found on studies of the effectiveness of Icelandic primary care physicians in diagnosing and treating mental illness. However, it is likely that the Icelandic primary health care system is not significantly different from systems in other countries that show poor detection and treatment of mental illness. The present study is the first study aimed at evaluating Icelandic primary care physicians’ experience with mental health problems and perceived competence in detection and treatment of behavior disorders. Furthermore, it is the first empirical attempt to assess the need for improved primary mental health care in Iceland. This exploratory study was designed to assess primary care physician’s perception of: 1) Prevalence and significance of different behavior disorders in the primary health care clinics, 2) their ability to detect and treat behavior disorders within the primary health care system, 3) the physician’s access to mental health services as well as quality of communication with mental health professionals, and 4) barriers to adequate mental health care within the Icelandic primary health care system. Main results suggest that Icelandic primary care physicians correctly identify that they, among all health care workers, are the ones seeing the highest proportion of people in the community suffering from mental health problems. -
Mary Black Memorial Hospital
MEDICAL STAFF RULES & REGULATIONS Board of Directors: July 25, 2017 Table of Contents Page ARTICLE I Introduction 1.1 Definitions ..................................................................................................4 - 5 ARTICLE II Admission and Discharge 2.1 Admissions ................................................................................................ 6 - 7 2.2 Coverage and Call ..................................................................................... 7 - 9 2.3 Transfers ...................................................................................................... 10 2.4 Patients Who Are a Danger to Themselves or Others ................................. 10 2.5 Prompt Assessment ..................................................................................... 10 2.6 Discharge Orders and Instructions .............................................................. 11 2.7 Discharge Against Medical Advice ............................................................... 11 ARTICLE III Medical Records 3.1 Authentication of Entries ............................................................................. 11 3.2 Clarity, Legibility, and Completeness .................................................... 11 - 12 3.3 Abbreviations and Symbols ......................................................................... 12 3.4 Correction of Errors ..................................................................................... 12 3.5 History and Physical Examination ........................................................ -
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. -
Tic Disorders
No. 35 May 2012 Tic Disorders A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics can occur in any body part, such as the face, shoulders, hands or legs. They can be stopped voluntarily for brief periods. Sounds that are made involuntarily (such as throat clearing, sniffing) are called vocal tics. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life. The most common tic disorder is called "transient tic disorder" and may affect up to 10 percent of children during the early school years. Teachers or others may notice the tics and wonder if the child is under stress or "nervous." Transient tics go away by themselves. Some may get worse with anxiety, tiredness, and some medications. Some tics do not go away. Tics which last one year or more are called "chronic tics." Chronic tics affect less than one percent of children and may be related to a special, more unusual tic disorder called Tourette's Disorder. Children with Tourette's Disorder have both body and vocal tics (throat clearing). Some tics disappear by early adulthood, and some continue. Children with Tourette's Disorder may also have problems with attention, and learning disabilities. They may act impulsively, and/or develop obsessions and compulsions. Sometimes people with Tourette's Disorder may blurt out obscene words, insult others, or make obscene gestures or movements. They cannot control these sounds and movements and should not be blamed for them. -
2013 Education Resolutions
2013 Agenda for the Reference Committee on Education National Conference of Special Constituencies—Sheraton Kansas City Hotel at Crown Center Item No. Resolution Title 1. Resolution No. 2001 Educate Adolescents on Consensual Sex (Don’t Rape) 2. Resolution No. 2002 Promotion of Forensic Sexual Assault & Child Abuse Examination Training 3. Resolution No. 2003 Enhancing the Training of Family Physicians in Addiction Medicine 4. Resolution No. 2004 Curriculum for End-of-Life Care 5. Resolution No. 2005 Education Resources for Non-Pharmacologic Approaches to Chronic Disease 6. Resolution No. 2006 Educational Resources for Environmental Influences on Health and Disease Processes 7. Resolution No. 2007 Resident Training in Reproductive Options 8. Resolution No. 2008 Breastfeeding Educations for Patients and Providers 9. Resolution No. 2009 Protected Time for Organized Medicine in Residency Education 10. Resolution No. 2010 Collaboration with Non-Physician Medical Providers 11. Resolution No. 2011 AAFP Advocates to American Board of Family Medicine on Behalf of Those Holding Certificates of Added Qualifications 12. Resolution No. 2012 Partnership and Promotion of Family Medicine to International Medical Graduate Residency Applicants 13. Resolution No. 2013 Education to Combat Gender Inequality for Family Medicine Physicians 4/26/2013 Page 1 of 1 Resolution No. 2001 2013 National Conference of Special Constituencies—Sheraton Kansas City Hotel at Crown Center 1 Educate Adolescents on Consensual Sex (Don’t Rape) 2 3 Submitted by: Cathleen London, MD, Women 4 Divya Reddy, MD, Women 5 Melodie Mope, MD, Women 6 Regina Kim, MD, Women 7 Barbara Walker, MD, Women 8 9 WHEREAS, Ninety-nine percent of people who rape are men, and 10 11 WHEREAS, 8% of men admit committing acts that meet the legal definition of rape or attempted 12 rape. -
Anxiety Disorders in Children Revised 2020
Information about: Anxiety Disorders in Children Revised 2020 Vermont Family Network 600 Blair Park Road, Ste 240 Williston, VT 05495 1-800-800-4005 www.VermontFamilyNetwork.org Introduction According to The Child Mind Institute, “Children with anxiety disorders are overwhelmed by feelings of intense fear or worry that they are out of proportion to the situation or thing that triggers them. These emotional fears can be focused on separating from parents, physical illness, performing poorly, or embarrassing themselves. Or they can be attached to specific things, like dogs or insects or bridges.” We hope that this will give you a greater understanding of anxiety disorders and the ways that parents and professionals can support children at home, in school, and in the community. We have selected information from various sources and provided internet links when possible. The information we have presented was used by permission from various sources. We have provided links for you to find more, in-depth information at their sites. Contents Title Page Anxiety Disorders in Children and Adolescents 2 Additional Treatments and Guidance 2 The Anxious Child 3 Anxiety Quick Fact Sheet for School Personnel & 4 Parents/Guardians Children Who Won’t Go to School (Separation Anxiety) 6 Managing Anxiety with Siblings 6 Panic Disorder in Children and Adolescents 7 Parenting Tips for Anxious Kids 8 Getting Linked (local resources) 9 Advocating for Your Child: 25 Tips for Parents 10-12 Resources 13 Anxiety Disorders in Children and Adolescents What Are Anxiety Disorders? According to The National Alliance on Mental Illness (NAMI)*, “Anxiety disorders are the most common mental health concern in the United States. -
Y-BOCS™ (Yale-Brown Obsessive-Compulsive Scale) Principal Developer: Wayne K. Goodman, M.D. Co-Developers: Steven A. Rasmussen
FIRST EDITION 9/89 (Revised 05/20) Y-BOCS™ (Yale-Brown Obsessive-Compulsive Scale) Principal Developer: Wayne K. Goodman, M.D. Co-developers: Steven A. Rasmussen, M.D. Lawrence H. Price, M.D. Eric A. Storch, PhD. Investigators interested in using this rating scale should contact Dr. Goodman at <[email protected]>. © 1989, 2017 Wayne Goodman Additional information regarding the development, use, and psychometric properties of the Y-BOCS™ can be found in Goodman WK, Price LH, Rasmussen SA, et al.: The Yale-Brown Obsessive Compulsive Scale: Part I. Development, use, and reliability. Arch Gen Psychiatry (46:1006-1011, 1989). and Goodman WK, Price LH, Rasmussen SA, et al.: The Yale-Brown Obsessive Compulsive Scale): Part II. Validity. Arch Gen Psychiatry (46:1012-1016, 1989). Copies of a version of the Y-BOCS™ modified for use in children, the Children's Y-BOCS™ (CY-BOCS™) (Goodman WK, Rasmussen SA, & Price LH,), or the second editions of the Y-BOCS-II™ and CY-BOCS-II™ are available from Dr. Goodman on request. Y-BOCS™ General Instructions This rating scale is designed to rate the severity and record the types of symptoms in a patient diagnosed with obsessive- compulsive disorder (OCD). In general, the items depend on the patient's report; however, the final rating is based on the clinical judgment of the interviewer. Rate the characteristics of each item during the prior week up until and including the time of the interview. Scores should reflect the average (mean) occurrence of each item for the entire week. This rating scale is intended for use as a semi-structured interview. -
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]. -
Self-Ambivalence in Obsessive-Compulsive Disorder
Self-Ambivalence in Obsessive-Compulsive Disorder Sunil S Bhar Submitted in total fulfilment of the requirements of the degree of Doctor of Philosophy July, 2004 Produced on acid-free paper Department of Psychology University of Melbourne ii iii Abstract According to the cognitive model, Obsessive-compulsive disorder (OCD) is maintained by various belief factors such as an inflated sense of responsibility, perfectionism and an overestimation about the importance of thoughts. Despite much support for this hypothesis, there is a lack of understanding about the role of self-concept in the maintenance or treatment of OCD. Guidano and Liotti (1983) suggest that individuals who are ambivalent about their self-worth, personal morality and lovability use perfectionistic and obsessive compulsive behaviours to continuously restore self- esteem. This thesis develops a model of OCD that integrates self-ambivalence in the cognitive model of OCD. Specifically, it explored the hypothesis that the OCD symptoms and the belief factors related to the vulnerability of OCD are mechanisms that provide relief from self- ambivalence. It addressed three questions. First, is self-ambivalence related to OCD symptoms and OCD-related beliefs? Second, to what extent is self-ambivalence specific to OCD, compared to other anxiety disorders? Third, to what extent is self-ambivalence important in accounting for response and relapse of OCD to psychological interventions? In order to explore these questions, a questionnaire measuring self- ambivalence was first developed and evaluated. Non clinical and clinical participants were recruited for research. Non-clinical participants (N = 269) comprised undergraduate students (N = 226: mean age = 19.55; SD = 3.27) and community controls (N = 43; mean age = 43.78; SD = 3.92). -
Quick-View Guides
Appendix A Quick-View Guides Compiled by Jennifer S. Mills 310 APPENDIX A QUICK-VIEW GUIDES 311 312 APPENDIX A QUICK-VIEW GUIDES 313 314 APPENDIX A QUICK-VIEW GUIDES 315 316 APPENDIX A QUICK-VIEW GUIDES 317 Appendix B Reprinted Measures Measures for Anxiety and Related Constructs 322 APPENDIX B Anxiety Control Questionnaire (ACQ) Listed below are a number of statements describing a set of beliefs. Please read each statement carefully and, on the 0–5 scale below, indicate how much you think each statement is typical of you. 1. I am usually able to avoid threat quite easily. 2. How well I cope with difficult situations depends on whether I have outside help. 3. When I am put under stress, I am likely to lose control. 4. I can usually stop my anxiety from showing. 5. When I am frightened by something, there is generally nothing I can do. 6. My emotions seem to have a life of their own. 7. There is little I can do to influence people’s judgments of me. 8. Whether I can successfully escape a frightening situation is always a matter of chance with me. 9. I often shake uncontrollably. 10. I can usually put worrisome thoughts out of my mind easily. 11. When I am in a stressful situation, I am able to stop myself from breathing too hard. 12. I can usually influence the degree to which a situation is potentially threatening to me. 13. I am able to control my level of anxiety. 14. There is little I can do to change frightening events. -
Neurobiology of the Premonitory Urge in Tourette Syndrome: Pathophysiology and Treatment Implications
View metadata, citation and similar papers at core.ac.uk brought to you by CORE HHS Public Access provided by Aston Publications Explorer Author manuscript Author ManuscriptAuthor Manuscript Author J Neuropsychiatry Manuscript Author Clin Neurosci Manuscript Author . Author manuscript; available in PMC 2017 April 28. Published in final edited form as: J Neuropsychiatry Clin Neurosci. 2017 ; 29(2): 95–104. doi:10.1176/appi.neuropsych.16070141. Neurobiology of the premonitory urge in Tourette syndrome: Pathophysiology and treatment implications Andrea E. Cavanna1,2,3,*, Kevin J Black4, Mark Hallett5, and Valerie Voon6,7,8 1Department of Neuropsychiatry Research Group, BSMHFT and University of Birmingham, Birmingham, UK 2School of Life and Health Sciences, Aston University, Birmingham, UK 3University College London and Institute of Neurology, London, UK 4Departments of Psychiatry, Neurology, Radiology, and Anatomy & Neuroscience, Washington University School of Medicine, St. Louis, MO, USA 5Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA 6Department of Psychiatry, University of Cambridge, Cambridge, UK 7Behavioural and Clinical Neurosciences Institute, Cambridge, UK 8Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK Abstract Motor and vocal tics are relatively common motor manifestations identified as the core features of Tourette syndrome. Although traditional descriptions have focused on objective phenomenological