Tourette Syndrome and Tic Disorders

Abstract

Tourette syndrome is a childhood‐onset neuropsychiatric condition marked by the chronic presence of motor and vocal tics. Pharmacotherapy has traditionally been the treatment of choice for managing Tourette syndrome, but a growing body of evidence suggests that behavioral interventions may be equally useful. This chapter provides an overview of Tourette syndrome and chronic tic disorders, and a discussion of various cognitive behavioral approaches to treatment. Evidence for each of these approaches is reviewed, and potential mediators and moderators relevant to psychosocial interventions for Tourette syndrome are discussed. Finally, a sample case is presented to illustrate the use of these therapeutic techniques in practice.

Scoping Review of Multidisciplinary Care in Tourette Syndrome

“…Given the complexity of TS and its associated comorbidities, no single healthcare provider could provide care for all the symptoms and the affected individual as a whole 23 . For instance, comorbid anxiety or depression are commonly managed using cognitive‐behavioral therapy (CBT), but neurologists are not trained to use this technique 3 . “The goals for the treating health care team are to identify the presence of these factors, to clarify which are the major source of distress, and develop an individualized multimodal treatment program.” 30 As such, comorbid disorders rather than tics mainly drive impairment for many individuals with TS.…”

“…Most of the included citations tangentially addressed the multidisciplinary care in TS relating to its complexity and associated comorbidities 3,7,[18][19][20][21][22] or for pre-operative evaluation for deep brain stimulation (DBS). 6,[18][19][20][21][22][23][24][25][26]…”

“…Tics naturally fluctuate and change over time and in different settings (eg, triggers) 2 . Individuals with TS can experience distress and impairment from their tics: (1) physical, such as pain and personal injury from tic performance; (2) social such as social isolation and bullying; (3) personal, such as low self‐esteem, increased risk of suicide and substance abuse; and (4) academic/vocational such as lower academic achievements and lower socioeconomic status 3–8 …”

“…2 Individuals with TS can experience distress and impairment from their tics: (1) physical, such as pain and personal injury from tic performance; (2) social such as social isolation and bullying; (3) personal, such as low self-esteem, increased risk of suicide and substance abuse; and (4) academic/vocational such as lower academic achievements and lower socioeconomic status. [3][4][5][6][7][8] Besides tics, individuals with TS commonly experience comorbid disorders. 9 Attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), mood disorders (such as anxiety and depression), socially inappropriate behaviors, learning difficulties, and insomnia are some of those comorbidities.…”