Impulse-Control Disorders in Gilles de la Tourette Syndrome

Abstract

Impulse-control disorders (ICDs) are more common in clinic populations with Gilles de la Tourette syndrome (GTS) than in the general population. The clinical phenomenology of ICDs differ between men with GTS (who tend to be externally impulsive) and women with GTS (who tend to be internally impulsive). This article reviews the relevant literature to-date on impulsivity in GTS, with special focus on intermittent, explosive disorder, self-injurious behavior, trichotillomania, and impulsive-compulsive sexual behavior. The medical and legal community should be aware of the full spectrum of organically-based behaviors that may predispose patients with GTS to unwanted legal disciplinary action.

Trichotillomania and personality traits from the five-factor model

“…24 This is not surprising, given the widely recognized relationship between TTM, TS, and OCD. 25 Given differences in comorbid personality profiles for TS 26 and the earlier age of onset of tics, it may be the case that personality may mediate pulling behavior differently in those with TS.…”

Histaminergic modulation in Tourette syndrome

“…Around 90% of patients with TS are diagnosed with co-morbid psychiatric disorders [16,18,19]. The most common behavioral co-morbidities are obsessivecompulsive disorder [20,21] and attention deficit and hyperactivity disorder [22,23], although affective disorders [24] and impulse control disorders [25][26][27] have been reported more commonly in patients with TS than in the general population.…”

Comparing two basic subtypes in OCD across three large community samples: a pure compulsive versus a mixed obsessive–compulsive subtype

“…Impulsivity and compulsivity have been conceptualized as two opposite ends of a dimension [69]. In fact, diagnoses/syndromes associated with high impulsivity (such as ADHD) and mixed compulsive-impulsive diagnoses (such as the Gilles de la Tourette syndrome [69]) were linked to the MOCS, and not to the PCS, in our data. Hence, the inverse relation between impulsivity and compulsivity may be reflected by our two distinct OCD subtypes.…”

“…Subjects with bulimia and anorexia-binge/ purging subtype exhibited higher impulsive traits than subjects with anorexia nervosa-restricting subtype, leading to the suggestion that this personality trait may reflect a shared underlying vulnerability for the comorbidity between OCD and eating disorders [4]. Impulsivity and compulsivity have been conceptualized as two opposite ends of a dimension [69]. In fact, diagnoses/syndromes associated with high impulsivity (such as ADHD) and mixed compulsive-impulsive diagnoses (such as the Gilles de la Tourette syndrome [69]) were linked to the MOCS, and not to the PCS, in our data.…”