Severe Self-Injurious Behavior With Teeth Extraction in a Boy With Tourette Syndrome

D, Krüger; Müller‐Vahl, Kirsten

doi:10.1016/j.pediatrneurol.2015.02.003

Cited by 6 publications

(2 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors reported about a 17-year-old male patient with malignant GTS who developed severe head tics that led to head trauma and subdural and subarachnoid haemorrhage followed by massive edema managed with decompressive craniotomy. Krüger and Müller-Vahl (10) published a case report of malignant GTS with self-extraction of teeth. Hood et al (11) reported about severe self-inflicted oral lacerations in GTS.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Correlates of Self-Harm Behaviors in Gilles de la Tourette Syndrome

2019

View full text Add to dashboard Cite

Introduction: Major symptoms of Gilles de la Tourette syndrome (GTS) are tics, but in 90% of cases, psychiatric comorbidities occur. Self-harm behaviors (SHBs) could result from deliberate action and unintentional injury from tics. Methods: We examined 165 consecutive GTS patients aged 5 to 50 years (75.8% males). The median duration of GTS was 14 years (interquartile range, 9–22 years). The patients were evaluated for GTS and comorbid mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Self-harm behavior was diagnosed during the interview. To determine a direct relationship between SHB and clinical variables, we conducted two analyses, at the time of evaluation and lifetime. We also compared the group of children and adults with SHB. We also tried to distinguish between deliberate (non–tic-related SHB) and accidental (tic-related SHB). Results: Lifetime SHB was reported by 65 patients (39.4%), and in 55 of the cases, it was present at the time of evaluation. The age at the onset of SHB was reported in 55 of the cases (84.6%), and the median was 10 years (interquartile range, 7–13 years). In 30 of the patients (46.2%), SHB was evaluated as mild; in 26 (40%), as moderate; and in only 9 cases (13.9%), as severe. In the multivariable analysis for the predictor of lifetime SHB, attention-deficit/hyperactivity disorder (p = 0.016) and obsessive-compulsive disorder (OCD; p = 0.042) were determined as risk factors, while for current SHB, only tic severity (p < 0.0001) was statistically significant. When comparing predictors of SHB for children and adults, tic severity was determined as predictor for lifetime SHB in children (p < 0.0001), while the anxiety disorder was associated with lifetime SHB in adults (p = 0.05). Similarly, tic severity was a predictor of current SHB in the children group (p = 0.001), but this was not confirmed for adults. The group of patients with tic-related and non–tic-related SHB did not differ. Conclusions: Self-harm behavior appears mostly in children and adolescents and rarely begins in adulthood. Self-harm behavior is associated mainly with tic severity, obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder. Clinical correlates of SHB are age related and differ at different points of life. Tic severity is the main factor associated with SHB in children. In the adult group, anxiety disorder and other psychiatric comorbidities may play the most important role.

show abstract

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Correlates of Self-Harm Behaviors in Gilles de la Tourette Syndrome

2019

View full text Add to dashboard Cite

show abstract

“…A description of an older male presenting with late onset OCD and genital self-mutilation has been published from India, the closest neighbour to Sri Lanka (Pandit & Vardhan 2013). There are cases of Tourette's disorder with comorbid OCD presenting with severe self-injurious behaviour (Krüger & Müller-Vahl 2015). In a series of patients with self-injurious skin picking, 52% of them was found to be suffering from comorbid OCD (Wilhelm et al 1999).…”

Section: Introductionmentioning

confidence: 99%

Serious Bodily Harm Related to Obsessions From Sri Lanka

Chandradasa

Champika²,

Hettiarachchi

et al. 2017

Psychiat Danub

View full text Add to dashboard Cite

Symptom Network Analysis in a Large Sample of Children and Adults with a Chronic Tic Disorder

Forlim,

Brandt,

Jakubovski

et al. 2024

Movement Disord Clin Pract

View full text Add to dashboard Cite

BackgroundChronic tic disorders (CTD) are multifaceted disorders characterized by multiple motor and/or vocal tics. They are often associated with complex tics including echophenomena, paliphenomena, and coprophenomena as well as psychiatric comorbidities such as attention deficit/hyperactivity disorder (ADHD) and obsessive‐compulsive disorder (OCD).ObjectivesOur goal was to uncover the inter‐relational structure of CTD and comorbid symptoms in children and adults and to understand changes in symptom structure across development.MethodsWe used network and graph analyses to uncover the structure of association of symptoms in childhood/adolescence (n = 529) and adulthood (n = 503) and how this structure might change from childhood to adulthood, pinpointing core symptoms as a main target for interventions.ResultsThe analysis yielded core symptom networks in young and adult patients with CTD including complex tics and tic‐related phenomena as well as touching people and objects. Core symptoms in childhood also included ADHD symptoms, whereas core symptoms in adults included symptoms of OCD instead. Interestingly, self‐injurious behavior did not play a core role in the young CTD network, but became one of the central symptoms in adults with CDT. In addition, we found strong connections between complex motor and vocal tics as well as echolalia and echopraxia.ConclusionsNext to other complex tics, echophenomena, paliphenomena, and coprophenomena can be regarded core symptoms of CTD. ADHD symptoms are closely related to CTD in childhood, whereas symptoms of OCD and self‐injurious behavior are closely associated with CTD in adults. Our results suggest that a differentiation between motor and vocal tics is somewhat arbitrary.

show abstract

Severe Self-Injurious Behavior With Teeth Extraction in a Boy With Tourette Syndrome

Cited by 6 publications

References 6 publications

Prevalence and Clinical Correlates of Self-Harm Behaviors in Gilles de la Tourette Syndrome

Prevalence and Clinical Correlates of Self-Harm Behaviors in Gilles de la Tourette Syndrome

Serious Bodily Harm Related to Obsessions From Sri Lanka

Symptom Network Analysis in a Large Sample of Children and Adults with a Chronic Tic Disorder

Contact Info

Product

Resources

About