Psychiatrische aspecten van tics

BACKGROUND: Tics, the most serious form of which is the Gilles de la Tourette syndrome (GTS), belong to the group of hyperkinetic movement disorders. The most extreme forms of these movement disorders are often characterised by psychiatric comorbidity.

AIM: To acquaint the reader with the psychiatric aspects of tics and with the role played by comorbidities in OCD and ADHD patients who also suffer from tics.

METHOD: Recent new insights in psychiatric aspects of GTS are described.

RESULTS: Tics in GTS have marked psychological characteristics because of their relatively capricious nature, their suppressibility and their reaction to environmental stimuli. Consequently, for the treatment of tics - but not for the treatment of other movement disorders - behaviour therapy is just as effective as dopaminergic medication. Psychiatric comorbidity (present in up to 65% of clinical populations with GTS) plays a crucial role in the course of tics disorder. In particular, ADHD and OCD patients who are also suffering from tics are more likely to be referred to psychiatric outpatiënt clinics because of their ADHD or OCD status than because of their tics.

CONCLUSION: GTS belongs to the domain of psychiatry because of the psychological aspects of tics, the feasibility of treatment with behaviour therapy and the crucial role played by comorbidity in the course of the disorder.