Lifetime Prevalence, Age of Risk, and Genetic Relationships of Comorbid Psychiatric Disorders in Tourette Syndrome

Hirschtritt, Matthew E.; Lee, Paul C.; Pauls, David L.; Dion, Yves; Grados, Marco A.; Illmann, Cornelia; King, Robert A.; Sandor, Paul; McMahon, William M.; Lyon, Gholson J.; Cath, Daniëlle C.; Kurlan, Roger; Robertson, Mary M.; Osiecki, Lisa; Scharf, Jeremiah M.; Mathews, Carol A.

doi:10.1001/jamapsychiatry.2014.2650

Cited by 568 publications

(503 citation statements)

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“…The high rates of co-occurring psychiatric disorders in patients with GTS patients lend support to the hypothesis of shared/overlapping neural circuitry and genetic susceptibility [70][71][72] . Two studies analysed genome-wide genotyping data to examine the unique and shared components of GTS and OCD heritability attributable to common (polygenic) variation 54,73 .…”

Section: Shared Genetic Basis With Other Neuropsychiatric and Neurolomentioning

confidence: 72%

“…While OCD and ADHD have long been known to share heritability with GTS 70 , the shared genetic relationship between migraine and GTS is novel. GTS and migraine have been observed to co-occur more frequently than control rates 77 , and abnormal serotonin levels have been proposed in both disorders 78 .…”

Section: Shared Genetic Basis With Other Neuropsychiatric and Neurolomentioning

confidence: 99%

“…Depression also leads to lower QoL, and potentially to hospitalisation and suicide. It was suggested that the aetiology of the depression in the context of GTS was multifactorial 129 but not genetic 113 and may be related to the OCD 70 .…”

Section: Shared Genetic Basis With Other Neuropsychiatric and Neurolomentioning

confidence: 99%

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Gilles de la Tourette syndrome

Robertson

Eapen

Singer

et al. 2017

Nat Rev Dis Primers

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296

244

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The unstructured abstract of 200 words maximum should summarize the main points of the article. All information mentioned in the abstract must be addressed somewhere in the main article. The abstract should not contain references or display item citations. Gilles de la Tourette Syndrome (GTS), a reasonably common disorder, has had a long, tortuous and somewhat controversial history. First and well described in the 18th century 1,2 , the main features of GTS have, however, remained fairly constant. The core diagnostic features are multiple motor and one or more vocal (phonic) tics lasting for over a year. In addition, almost pathognomic, but not necessary, features described in the early documentations include coprolalia (involuntary, inappropriate swearing), and echophenomena (copying behaviours), as well as many co-morbidities and psychopathologies 3 . Introduction [suggested 500 words, is 544 words -8 refs] Mary Robertson Thoughts for Mary -Your word count when combining sections 1 and 2 is 1001 (1000 limit)-so OKGTS was originally described in France and the majority of early literature came from and standardised schedules such as diagnostic confidence, measurement of severity, QoL, and assessment of both co-morbidities and co-existent psychopathologies are currently available.Large international collaborative consortia are engaged in studies exploring aetiological factors in particular, and some international treatment studies are also underway. Perhaps as a result of earlier small patient numbers, the treatment trials have given good clues to management, but unsurprisingly systematic reviews and meta-analyses have been hampered, giving disappointing, if not unexpected, results. Intriguingly medications from the typical NRDP -Gilles de la Tourette Syndrome 3 antipsychotic family including haloperidol, which first had documented success in 1961 6,7 are still being used, although successive generations of "atypicals" are currently more in vogue,as are medications such as alpha-2-adrenergic agonists. Interestingly, haloperidol remains the only medication prescribed on licence in many parts of the world. In contrast to disorders such as ADHD, in which it is clear which treatments work and which do not require further study 8 , a variety of treatment studies in GTS are still being undertaken, including using other medications (trying to improve efficacy and reduce side effects), behavioural therapies, deep brain stimulation (for refractory cases), and other more "alternative" methods such as "orthotics" (teeth braces). The GTS community has to first agree on how common GTS is and then seek funding for research in the areas of major importance.2. Epidemiology [suggested 500 words, is 444 words, 6 additional refs] Mary Robertson GTS was for many years thought to be not only very rare, but a bizarre curiosity, with sporadic case reports peppering the literature. The belief that GTS was uncommon at the very least was held by many until Comings 9 controversially suggested that GTS occurred in between 0.66% and...

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Section: Shared Genetic Basis With Other Neuropsychiatric and Neurolomentioning

confidence: 72%

Section: Shared Genetic Basis With Other Neuropsychiatric and Neurolomentioning

confidence: 99%

See 1 more Smart Citation

Gilles de la Tourette syndrome

Robertson

Eapen

Singer

et al. 2017

Nat Rev Dis Primers

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296

244

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“…Relatively little research has been devoted to the group of child and adolescent patients with diseases of the nervous system, in whom there simultaneously appear signs of a spectrum of mental disorders that require treatment. The comorbidity of neurological and psychiatric disorders has been described, among others, in children with headaches [13,14], migraine [15], tic disorder [16], Tourette's syndrome [17], juvenile multiple sclerosis [18] and epilepsy [7,19]. The present work discusses the characteristics of patients from a diagnostic developmental neurology department, who manifested severe signs of mental problems and, as a result, were in need of a psychiatric consultation.…”

Section: Introductionmentioning

confidence: 92%

Symptoms of psychiatric diseases in a pediatric neurology department

Kaczmarek¹,

Kucharska²,

Cioczek³

et al. 2017

Arch Med Sci Civil Dis

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Introduction: The present study investigated the comorbidity of psychiatric symptoms among patients with neurological diseases and the possibility of the symptoms of mental disorders being masking by the symptoms of somatic disorders. Material and methods: Eight thousand two hundred and one epicrises of all patients hospitalized at the Department of Developmental Neurology from 1st January 2003 to 31st December 2013 were analyzed in order to select a group of patients referred for consultation with a child psychiatrist. The epicrises were analyzed in terms of diagnosis and the most common psychopathological symptoms on the basis of the State-Trait Anxiety Inventory, State-Trait Anxiety Inventory for Children, Eysenck Personality Questionnaire-Revised, Beck Depression Inventory, and the Schedule for Affective Disorders and Schizophrenia for School-Aged Children – Present and Lifetime (K-SADS-PL). Results: As a result of the analysis a group of 345 patients with serious symptoms requiring psychiatric consultation was selected. In the selected group, patients had the diagnosis of neurological as well as psychiatric diseases. The most frequently mentioned were: epilepsy (13.3%), emotional disorders (11.3%), tension-type headaches (11.3%) and conversion disorders (8.4%). Dominating psychopathological symptoms were: anxiety (64%), symptoms of mood disorders (31.6%) and signs of inattention (19.7%). Suicidal ideation was manifested by 21 (6.08%) persons. Conclusions: There is a need for careful observation of the mental state of each patient of a pediatric neurology department by an interdisciplinary team of doctors, psychologists and support staff.

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“…5 These comorbid disorders are often associated with more distress and impairment than tics themselves.…”

mentioning

confidence: 99%

Child Neurology: Diagnosis and treatment of Tourette syndrome

Hirschtritt

Yang

et al. 2016

Neurology

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A 16-year-old left-handed boy with Tourette syndrome (TS) presented to the outpatient neurology clinic complaining of difficulty focusing and completing tasks resulting in impairment at home, school, and social gatherings. He developed recurrent sniffing and throat clearing at age 6, which waxed and waned over time, and had since experienced repeated movements of the head, face, hands, and legs and gulping vocalizations; a diagnosis of TS was established at age 7. His tics were preceded by a premonitory sensation and were partially suppressible. These symptoms led to discomfort, but not impairment. He struggled with planning and organizational skills since age 6, and at age 12 developed repeated washing and writing/ rewriting rituals. Family history was notable for a maternal grandmother with attention-deficit/hyperactivity disorder (ADHD) and a father with repetitive eye-blinking and possible childhood obsessive-compulsive disorder (OCD). He had a normal birth followed by normal developmental milestones. Neurologic examination including smooth pursuit and voluntary saccadic eye movements was unremarkable.TS is a developmental neuropsychiatric disorder characterized by multiple, recurrent, usually brief, nonrhythmic motor movements and at least one vocalization (motor and phonic tics, respectively) that have onset before age 18, persist for 1 year, and are not due to medications or another medical condition.

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Lifetime Prevalence, Age of Risk, and Genetic Relationships of Comorbid Psychiatric Disorders in Tourette Syndrome

Cited by 568 publications

References 44 publications

Gilles de la Tourette syndrome

Gilles de la Tourette syndrome

Symptoms of psychiatric diseases in a pediatric neurology department

Child Neurology: Diagnosis and treatment of Tourette syndrome

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