Core features and associated psychopathology of Tourette syndrome: modifications by cultural aspects?

Rothenberger, Aribert; Becker, Andreas; Rothenberger, Lillian Geza

doi:10.1007/s00787-013-0407-9

Cited by 3 publications

(2 citation statements)

References 3 publications

(9 reference statements)

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“…Further, one should have in mind that some psychopathological symptoms might be influenced by the cultural context. Hence, in the case of TS, empirical data revealed that there may exist "culturally resistant" core features of TS which are related to motor and vocal tics while merely distant TS associated psychopathology like mood problems may be (at least partly) "culturally sensitive" [13].…”

Section: Associated Psychopathologymentioning

confidence: 99%

Psychopharmacotherapy of Obsessive-Compulsive Symptoms within the Framework of Tourette Syndrome

Rothenberger

Roessner

2019

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While Behavioral Therapy (BT) should be recommended as the first step in the treatment of OCD as well as TS, medication can be added for augmentation and in certain situations (e.g. family preference, BT not available or feasible) the priority may even reverse. This narrative review is given on the complexity of drug treatment in patients comorbid for obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) and other tic problems. OCD with TS is a co-occuring combination of two generally delimitable, but in detail also overlapping disorders which wax and wane with time but have different courses and necessities and options of treatment. Distinct subtypes like "tic-related OCD" are questionable. Obsessive-compulsive symptoms (OCS) and tics are frequently associated (OCS in TS up to 90%, tics in OCD up to 37%). Sensory-motor phenomena like urges and just-right feelings reflect some behavioral overlap. The main additional psychopathologies are attention-deficit hyperactivity disorder (ADHD), mood problems and anxiety. Also, hair pulling disorder and skin picking disorder are related to OCD with TS. Hence, the assessment and drug treatment of its many psychopathological problems needs high clinical experience, careful planning, and ongoing evaluation/adaptation. Drugs are able to reduce clinical symptoms but cannot cure the disorders, which should be treated in parallel in their own right; i.e. for OCD serotonin reuptake inhibitors (SSRI) and for TS (tics) certain antipsychotics can be successfully prescribed. In cases of OCD with tics, when OCS respond only partially, an augmentation with antipsychotics (recommended: aripiprazole and risperidone) may improve OCS as well as tics. Also, the benzamide sulpiride, an atypical antipsychotics, may be beneficial in treating the combination of OCS, tics and anxious-depressive problems. Probably, any additional psychopathologies of OCD might attenuate the effectiveness of SSRI on OCS; on the other hand, in cases of OCD with tics, SSRI may reduce not only OCS but also stress sensitivity and emotional problems and thus leading to better selfregulatory abilities, useful to improve tic suppression. In sum, some clinical guidance can be given, but there remain many uncertainties because of a scarce data base for psychopharmacotherapy in OCD with TS. Recently, a high quality primer on Tourette Syndrome (TS) has been published, giving a timely and comprehensive overview related to all relevant aspects of the disorder [1]. This includes the suggestion that primarily Behavior Therapy (BT) should be recommended for the treatment of both OCS/OCD and TS. BT seems to be equally effective for pure as well as tic-related OCD [2-4]. But many patients remain symptomatic after BT intervention. In this situation, medication comes into play for augmentation. Further, drug treatment may be given the priority if BT is not available, not feasible or not preferred by the family. Concerning the practically important relationship between obsessive-compulsive symptoms (OCS) and TS the present r...

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Section: Associated Psychopathologymentioning

confidence: 99%

Psychopharmacotherapy of Obsessive-Compulsive Symptoms within the Framework of Tourette Syndrome

Rothenberger

Roessner

2019

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“…For example, this group of patients presents as many sleep problems as TS patients, with a burden of five other comorbidities [10,41]. The latter, as well as cultural influences [42], makes it difficult to decide if clinically observed sleep problems in TS/ TD reflect a core symptom of the disorder or are merely a secondary reactive issue of clinical relevance. Further, within the context of TS/TD-associated anxiety and depression, it has to be noted that "sleep problems both predict and are predicted by a diagnostic cluster that includes oppositional defiant disorder, general anxiety disorder and depression" [43].…”

Section: Sleep Problems In Ts and Td: An Overview Of The Existing Litmentioning

confidence: 99%

Sleep in Tourette Syndrome

Kirov

Becker

Rothenberger

2014

Curr Dev Disord Rep

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Tourette syndrome (TS) is a heritable developmental neuropsychiatric disorder and is defined as part of a spectrum of motor and vocal tic disorders (TD). Sleep problems are a common feature associated with TS/TD. They may affect daytime tic expression and neurobehavioral functioning. However, sleep studies on TS/TD are still scarce, and firm conclusions about the relationship of tics and sleep are difficult to draw. In this review, we summarize the existing knowledge about sleep problems in TS/TD and advocate for better understanding of their nature. Neglected links between the neurobiology of sleep and the psychophysiology of TS/TD and their psychiatric comorbidity, as well as medication for TS/TD, are highlighted, and future trends in sleep research on TS/TD are proposed.

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The Phenomenology of Attention-Deficit/Hyperactivity Disorder in Tourette Syndrome

Rothenberger¹,

Roessner²

2022

Tourette Syndrome

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This chapter focuses on the complex epidemiological and phenomenological aspects of attention-deficit/hyperactivity disorder (ADHD) in Tourette syndrome (TS). Research on this topic is relatively recent and elucidated the high importance of comorbidity in TS and the need for an early assessment of ADHD in TS. Several observational studies have confirmed that ADHD is the most common comorbidity in TS, possibly anticipating TS onset and influencing the male gender predominance of TS. ADHD exerts a negative impact on externalizing and internalizing symptoms, as well as on psychosocial functioning and quality of life in TS. The impact of comorbid ADHD upon sleep disturbances in TS remain a neglected issue. Approaches to model the coexistence of TS and ADHD are still ongoing. Whereas basic neurobiological aspects fit with an additive model, complex cognitive functioning supports an interactive model. Specific pathophysiological features for TS plus ADHD have not yet been identified, but common heritability between TS and ADHD might be explained, at least in part, by the comorbidity of ADHD and obsessive–compulsive disorder. Future studies on the phenomenology of TS plus ADHD should consider not only the core symptoms of TS and ADHD but also obsessive–compulsive behavior traits, emotional aspects, neuropsychological aspects, quality of life, early risk factors, resilience, and other possible mediators and moderators.

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Core features and associated psychopathology of Tourette syndrome: modifications by cultural aspects?

Cited by 3 publications

References 3 publications

Psychopharmacotherapy of Obsessive-Compulsive Symptoms within the Framework of Tourette Syndrome

Psychopharmacotherapy of Obsessive-Compulsive Symptoms within the Framework of Tourette Syndrome

Sleep in Tourette Syndrome

The Phenomenology of Attention-Deficit/Hyperactivity Disorder in Tourette Syndrome

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