Comorbidity in Pediatric OCD

2017 ◽  
Author(s):  
Michael H. Bloch
Keyword(s):  
Tourette Syndrome ◽  
Attention Deficit ◽  
Late Adolescence ◽  
Tic Disorders ◽  
Pharmacological Treatments ◽  
Pediatric Ocd ◽  
Male Preponderance ◽  
Definition Of

Tic disorders, including Tourette syndrome (TS), are not formally part of the category of “OCD-related disorders” in the DSM; but the association with OCD is sufficiently strong, and clinically important, that the OCD diagnosis now carries an optional “tic-related” specifier. Comorbidity is the norm in TS; in addition to OCD, attention deficit symptoms are particularly common. The presence of these comorbidities can affect both behavioral and pharmacological treatments, which are reviewed in this chapter. Tics commonly begin in childhood (part of the definition of TS), often improving in late adolescence. Approximately 30% of children with TS will develop OCD; the onset of OCD symptoms is usually later than that of tics, and they are more likely to persist into adulthood. Tic-associated OCD has a male preponderance and is more likely to be characterized by symmetry-related obsessions and compulsions. Like OCD, tic disorders are characterized by abnormalities in the cortico-striatal circuitry.

Tourette syndrome in children and adolescents: aetiology, presentation and treatment

2016 ◽  
Vol 22 (3) ◽  
pp. 165-175
Author(s):  
Mary May Robertson
Keyword(s):  
Tourette Syndrome ◽  
Caregiver Burden ◽  
Young Person ◽  
Simultaneous Presence ◽  
Pharmacological Treatments ◽  
Juvenile Onset ◽  
Male Preponderance ◽  
Psychiatric Conditions ◽  
Deep Brain

SummaryTourette syndrome is a complex neuropsychiatric disorder of juvenile onset, characterised by motor and phonic tics. It is associated with a number of comorbid psychiatric conditions and a reduced quality of life in the young person and with parenting stress, caregiver burden and psychopathology in the parents. The global prevalence (about 1%) is higher than previously thought, with a strong male preponderance. Evidence is emerging that Tourette syndrome is not a unified disorder; rather, it encompasses a number of subtypes, characterised by complexity of tics and the simultaneous presence of other behaviours or disorders. This article discusses the aetiology of the syndrome, and examines its clinical features and comorbid psychiatric conditions and psychopathologies. Assessment and diagnosis are also discussed. Psychoeducation is a cornerstone of management, augmented with behavioural and/or pharmacological treatments. Newer therapies, such as deep brain stimulation, offer tantalising possibilities, but further research is still needed.

Antineuronal Antibodies in Pediatric OCD and Tourette Syndrome

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Morer
Keyword(s):  
Tourette Syndrome ◽  
Clinical Features ◽  
Antibody Binding ◽  
Tic Disorders ◽  
Antineuronal Antibodies ◽  
Molecular Weights ◽  
Pediatric Ocd ◽  
Biological Features ◽  
Immunological Markers ◽  
History Of

The objective of our study was to test the autoimmune hypothesis of OCD and TS as disorders related with PANDAS, and find clinical features or specific immunological markers related with them. Child onset OCD in adults has been associated with higher mean ASLO titers, higher frequencies of history of tic disorders, tonsillitis in childhood and compulsive symptoms. Also, two proteins, with molecular weights of 86kDa and 55kDa, have shown antibody binding in sera from 7 patients.The fact that some clinical and biological features related with PANDAS are found in adults and that antineuronal antibodies exist in patients with OCD or TS diagnosis that don't meet PANDAS criteria, lends further evidence that autoimmunity related with OCD is wider than PANDAS.

scholarly journals Altered urinary tetrahydroisoquinoline derivatives in patients with Tourette syndrome: reflection of dopaminergic hyperactivity?

2020 ◽  
Author(s):  
Philipp Capetian ◽  
Veit Roessner ◽  
Caroline Korte ◽  
Susanne Walitza ◽  
Franz Riederer ◽  
...  
Keyword(s):  
Tourette Syndrome ◽  
Diagnostic Value ◽  
Tic Disorders ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Two Phase ◽  
Dopaminergic Neurotransmission ◽  
Hyperactivity Disorder ◽  
The Central Nervous System ◽  
Chronic Tic Disorders

AbstractTetrahydroisoquinolines (TIQs) such as salsolinol (SAL), norsalsolinol (NSAL) and their methylated derivatives N-methyl-norsalsolinol (NMNSAL) and N-methyl-salsolinol (NMSAL), modulate dopaminergic neurotransmission and metabolism in the central nervous system. Dopaminergic neurotransmission is thought to play an important role in the pathophysiology of chronic tic disorders, such as Tourette syndrome (TS). Therefore, the urinary concentrations of these TIQ derivatives were measured in patients with TS and patients with comorbid attention-deficit/hyperactivity disorder (TS + ADHD) compared with controls. Seventeen patients with TS, 12 with TS and ADHD, and 19 age-matched healthy controls with no medication took part in this study. Free levels of NSAL, NMNSAL, SAL, and NMSAL in urine were measured by a two-phase chromatographic approach. Furthermore, individual TIQ concentrations in TS patients were used in receiver-operating characteristics (ROC) curve analysis to examine the diagnostic value. NSAL concentrations were elevated significantly in TS [434.67 ± 55.4 nmol/l (standard error of mean = S.E.M.), two-way ANOVA, p < 0.0001] and TS + ADHD patients [605.18 ± 170.21 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] compared with controls [107.02 ± 33.18 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] and NSAL levels in TS + ADHD patients were elevated significantly in comparison with TS patients (two-way ANOVA, p = 0.017). NSAL demonstrated an AUC of 0.93 ± 0.046 (S.E.M) the highest diagnostic value of all metabolites for the diagnosis of TS. Our results suggest a dopaminergic hyperactivity underlying the pathophysiology of TS and ADHD. In addition, NSAL concentrations in urine may be a potential diagnostic biomarker of TS.

scholarly journals The prevalence of tic disorders in children and adolescents in Brazil

2014 ◽  
Vol 72 (12) ◽  
pp. 942-948 ◽  
Author(s):  
Helvio L. Alves ◽  
Elizabeth M. A. B. Quagliato
Keyword(s):  
Special Education ◽  
Children And Adolescents ◽  
Tourette Syndrome ◽  
Special Education Students ◽  
Tic Disorders ◽  
Education Students ◽  
Tic Disorder ◽  
Item Questionnaire ◽  
Chronic Tic Disorder

Tourette syndrome (TS) and tic disorders represent events of familiar magnitude characterized by involuntary movements and/or vocalization. To determine the prevalence of TS/tic disorders we studied a sample of 762 subjects (388 M, 374 F), between 1992 and 1997, age 6 to 43 years old, taken out of a population of 10,155 subjects (4,918 M, 5,237 F; age: 3-56 years old). A structured 4-item questionnaire, direct interview (multistaged), >1 yr follow-up, were used. 9,565 subjects (4,614 M, 4,951 F) sent back the questionnaires, 3,354 of these (1,671 M, 1,683 F) with positive answers to tics. 42 subjects (31 M, 11 F, age: 7-21 years old, mean: 11 years old) met the DSM-III-R criteria. The total minimal prevalence of TS is 0.43%, with a 3:1 ratio male/female. The minimal prevalence of chronic tic disorder is 2.27%. The total minimal prevalence for tic disorders at all is 2.91%. No special education students participation.

Development of Tics in a Thirteen-Year-Old Male Following Atomoxetine Use

CNS Spectrums ◽  
2008 ◽  
Vol 13 (4) ◽  
pp. 301-303 ◽  
Author(s):  
Jessica Sears ◽  
Nitin C. Patel
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Single Dose ◽  
Tourette Syndrome ◽  
Attention Deficit ◽  
Interventional Therapy ◽  
Prior History ◽  
Unique Case ◽  
Hyperactivity Disorder ◽  
History Of ◽  
Pharmacologic Therapies

ABSTRACTTics and Tourette syndrome are common comorbidities of patients diagnosed with attention-deficit/hyperactivity disorder (ADHD). One of the mainstay pharmacologic therapies for ADHD has been stimulants. However, this class of drugs has been associated with tic exacerbations, thus limiting their utility in this patients subgroup. Atomoxetine has been explored as an alternative treatment as one of the few non-stimulants available to treat ADHD. Early data identifies atomoxetine's influence on Tourette symptomatology to be not merely equivocal but potentially suppressive in the manifestation of tics. There are, however, case studies describing patients experiencing recurrences of tics following treatment with atomoxetine. We present a unique case of a patient, without any prior history of a movement disorder, who developed tics following a single dose of atomoxetine that did not improve until interventional therapy was initiated.

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