Comorbid Psychiatric Disorders in Tourette Syndrome: Neuropathology and Mental Health Needs for Tourette Syndrome Patients

Abstract

Tourette syndrome (TS) is a neurodevelopmental disease that typically starts in childhood or early adolescence. It has become increasingly prevalent in recent years. It is characterized by uncontrollable motor tics and sounds which usually are socially inappropriate. These impulses which cause these movements and sound are repetitive and intrusive for kids, accompanied with a sense of relief after tics. For TS patients, TS is not only a source of physical discomfort but also a significant cause of emotional distress and social impairment. Such anxiety and sensory stimuli would reinforce the urge, which triggers the tics and vocal outbursts. Moreover, TS frequently co-occurs with or evolves into other neurodevelopmental or psychiatric conditions during adolescence, such as obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders. In many cases, these comorbid conditions can be more impairing than the tics themselves. Although current evidence suggests that the mechanisms of comorbid disorders are similar with TS, their relationship and solution worth more attention and scientific resources. Therefore, the social and mental supports needed by TS patients are greater than previously recognized. While the exact genetic causes of TS remain unclear, research indicates that dysfunction in the dopaminergic system and abnormalities in the cortico-striato-thalamo-cortical (CSTC) circuits are among the key pathophysiological mechanisms. With deeper study in TS, more medication and therapy are found, and hopefully they would become more prevalent and targeted for TS patients in the future to alleviate their internal distress.