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Psychosomatics 2018Few publications deal with non-neurogenic language disorders (NNLDs), distinct from psychogenic speech disorders such as psychogenic dysphonia or stuttering. NNLDs are... (Review)
Review
BACKGROUND
Few publications deal with non-neurogenic language disorders (NNLDs), distinct from psychogenic speech disorders such as psychogenic dysphonia or stuttering. NNLDs are alterations in language owing to psychosomatic preoccupations, conversion disorder, psychiatric disorders, or other psychological reasons.
OBJECTIVE
To identify and classify the range of NNLDs and their characteristics.
METHODS
This review summarizes the literature on disturbances in language, broadly defined as the use of symbols for communication, which may have a psychogenic or psychiatric etiology.
RESULTS
The literature suggests a classification for NNLDs that includes psychogenic aphasia with dysgrammatism; psychogenic "lalias" including oxylalia and agitolalia, palilalia and echolalia, xenolalia, glossolalia, and coprolalia; psychologically-mediated word usage; psychotic language; and psychogenic forms of the foreign accent syndrome.
CONCLUSIONS
Clinicians and researchers have insufficiently emphasized the presence of NNLDs, their characteristics, and their identification. Yet, these disorders may be the first or predominant manifestation of a psychologically-mediated illness. There are 2 steps to recognition. The first is to know how to distinguish NNLDs from the manifestations of neurogenic language impairments after a neurological evaluation. The second step is awareness of specific associated and examination features that suggest the presence of a NNLD.
Topics: Humans; Language Disorders; Mental Disorders; Psychophysiologic Disorders
PubMed: 28911819
DOI: 10.1016/j.psym.2017.08.006 -
Neurologic Clinics May 1997Coprolalia has been a recognized symptom of Tourette syndrome from the first description of the syndrome. Copropraxia is seen less frequently and almost always occurs in... (Review)
Review
Coprolalia has been a recognized symptom of Tourette syndrome from the first description of the syndrome. Copropraxia is seen less frequently and almost always occurs in association with coprolalia. Prevalence of coprolalia varies from 8% in primary pediatric practices to over 60% in tertiary referral centers. Coprolalia tends to peak in severity during adolescence and to wane during adulthood. The pathogenesis may be related to dysfunction of basal ganglionic and limbic mini-circuits. Coprolalia has also been seen in a variety of other neurologic disorders. Treatment is primarily pharmacologic with dopamine-blocking agents.
Topics: Brain; Diagnosis, Differential; Humans; Language Disorders; Tourette Syndrome
PubMed: 9115463
DOI: 10.1016/s0733-8619(05)70314-5 -
Movement Disorders Clinical Practice Nov 2021TikTok is a social media platform where users create and share videos. During the COVID-19 pandemic, the use of this site greatly expanded. Tic and Tourette syndrome...
BACKGROUND
TikTok is a social media platform where users create and share videos. During the COVID-19 pandemic, the use of this site greatly expanded. Tic and Tourette syndrome content also increased dramatically along with the number of patients with tics in neurology clinics.
OBJECTIVES
We compared the phenomenology of "TikTok tics" to typical tic disorders. We chose to analyze the most widely viewed videos and therefore focused on the most popular content creators.
METHODS
Videos with the keywords "tic," "Tourette," or "tourettes" were reviewed to identify content creators between March 11, 2020 and March 30, 2021. We performed a quantitative assessment of TikTok tics as well as a descriptive analysis of the entire series of videos of each content creator.
RESULTS
The mean age of the cohort was 18.8 years old, and the majority were women. Unlike the predominance of facial movements in typical tics, arm movements were most frequent. Average tics per minute was 29, and almost all recorded TikTok tics were severe, causing significant disability. Whereas coprolalia and self-injurious behavior are only infrequently encountered in typical tic disorders, they were present in the overwhelming majority of TikTok subjects.
CONCLUSIONS
TikTok tics are distinct from what is typically seen in patients with Tourette syndrome, although share many characteristics with functional tics. We believe this to be an example of mass sociogenic illness, which involves behaviors, emotions, or conditions spreading spontaneously through a group. A modern clinician needs to remain abreast of social media sources as knowledge of media content is essential in managing patients in the current environment.
PubMed: 34765687
DOI: 10.1002/mdc3.13316 -
Psychiatry Research Dec 2016Coprolalia in neuropsychiatry is typically associated with tic disorders, in particular Gilles de la Tourette syndrome. To date, there has been no report of functional...
Coprolalia in neuropsychiatry is typically associated with tic disorders, in particular Gilles de la Tourette syndrome. To date, there has been no report of functional coprolalia. Here, we provide the clinical characteristics of 13 adolescent and adult patients with coprolalic and other functional tic-like complex vocalizations who, on the basis of these symptoms, were misdiagnosed with a primary tic disorder, most commonly Gilles de la Tourette syndrome. We describe similarities and highlight the differences from primary tic disorders in order to provide a pragmatic list of clinical clues that will facilitate correct diagnostic labeling and thereby treatment. Finally, we emphasize that the distinction between a primary and a functional tic disorder should rely on a combination of neuropsychiatric symptoms and signs and not on the presence of single, however striking, abnormal behaviors, such as coprolalia.
Topics: Adolescent; Adult; Child; Communication; Diagnostic Errors; Female; Follow-Up Studies; Humans; Male; Middle Aged; Problem Behavior; Tic Disorders; Tics; Tourette Syndrome; Young Adult
PubMed: 27825787
DOI: 10.1016/j.psychres.2016.10.021 -
Developmental Medicine and Child... Mar 2009The aims of this descriptive study were to examine the prevalence and associations of coprophenomena (involuntary expression of socially unacceptable words or gestures)...
The aims of this descriptive study were to examine the prevalence and associations of coprophenomena (involuntary expression of socially unacceptable words or gestures) in individuals with Tourette syndrome. Participant data were obtained from the Tourette Syndrome International Database Consortium. A specialized data collection form was completed for each of a subset of 597 consecutive new patients with Tourette syndrome from 15 sites in seven countries. Coprolalia occurred at some point in the lifetime of 19.3% of males and 14.6% of females, and copropraxia in 5.9% of males and 4.9% of females. Coprolalia was three times as frequent as copropraxia, with a mean onset of each at about 11 years, 5 years after the onset of tics. In 11% of those with coprolalia and 12% of those with copropraxia these coprophenomena were one of the initial symptoms of Tourette syndrome. The onsets of tics, coprophenomena, smelling of non-food objects, and spitting were strongly intercorrelated. Early onset of coprophenomena was not associated with its longer persistence. The most robust associations of coprophenomena were with the number of non-tic repetitive behaviors, spitting, and inappropriate sexual behavior. Although coprophenomena are a frequently feared possibility in the course of Tourette syndrome, their emergence occurs in only about one in five referred patients. Because the course and actual impact of coprophenomena are variable, additional prospective research is needed to provide better counseling and prognostic information.
Topics: Behavioral Symptoms; Child; Child, Preschool; Female; Humans; Language; Male; Social Behavior; Tics; Tourette Syndrome; Verbal Behavior
PubMed: 19183216
DOI: 10.1111/j.1469-8749.2008.03135.x -
Journal of Clinical Medicine Jun 2021Coprolalia and echophenomena repeated in the patients' mind (CTPh-cognitive tic-like phenomena) have been rarely recognized as part of Gilles de la Tourette syndrome...
Coprolalia and echophenomena repeated in the patients' mind (CTPh-cognitive tic-like phenomena) have been rarely recognized as part of Gilles de la Tourette syndrome (GTS) symptomatology and their assignment to tics, OCD or other psychopathologies has not been settled. The aim of the paper was to assess the incidence and clinical associations of CTPh in GTS, and to establish if CTPh belong to the tic spectrum. We performed a prospective, one-registration study on a cohort of 227 consecutive patients with GTS. CTPh were diagnosed during the interview and defined as brief, sudden, involuntary thoughts that had corresponding complex vocal tics. CTPh occurred at some point in the lives of 34 (15.0%) patients. The median age at onset of CTPh was 14.5 years (IQR: 10.5-17.5). CTPh were found more frequently in adults, with the most frequent onset in adolescence (44.1%). Four mental phenomena resembling tics were recognized: echolalia ( = 17), coprolalia ( = 16), palilalia ( = 13) and repeating of words in the mind ( = 7). The older the age of patients, the more severe tics, and anxiety disorder significantly correlated with CTPh. CTPh may be considered as a part of tic spectrum with a substantial impact of anxiety disorder. CTPh are a late and age-related symptom of GTS.
PubMed: 34206614
DOI: 10.3390/jcm10132749 -
Psychiatry and Clinical Neurosciences Dec 1997The purpose of this study is to examine whether there are differences in clinical characteristics between Tourette syndrome (TS) patients with and without 'generalized... (Clinical Trial)
Clinical Trial Comparative Study
The purpose of this study is to examine whether there are differences in clinical characteristics between Tourette syndrome (TS) patients with and without 'generalized tics' (GT) which involve the entire body, and/or coprolalia. Subjects were 64 patients (55 males and 9 females, mean age, 17.4 +/- 7.2 years) who visited Tokyo University's outpatient clinic of neuropsychiatry from 1974 to 1993 and who met criteria for Tourette's disorder of DSM-III-R. Data on clinical characteristics, including tic symptoms and courses of their development, complications and developmental histories, treatment and severity, were collected by systematic chart review of all subjects. Tourette syndrome patients with 'generalized tics' tended to show multiple complex vocal tics more frequently than TS patients without GT. Tourette syndrome patients with coprolalia tended to show significantly higher rates of copropraxia, echolalia, and 'cleaning/washing' compulsion than did the TS patients without coprolalia. Tourette syndrome patients with both GT and coprolalia were classified as the severest group in terms of tic symptoms and social impairment. Tourette syndrome patients who had neither of these morbidities were classified into the mildest group in all aspects. Generalized tics and coprolalia seemed to indicate the severest end of the TS spectrum and seemed to be related with a need of intensive treatment.
Topics: Adolescent; Adult; Female; Humans; Male; Psychiatric Status Rating Scales; Speech; Tic Disorders; Tourette Syndrome
PubMed: 9472118
DOI: 10.1111/j.1440-1819.1997.tb02599.x -
The American Journal of Psychiatry Apr 2017Phenotypic heterogeneity in Tourette syndrome is partly due to complex genetic relationships among Tourette syndrome, obsessive-compulsive disorder (OCD), and attention...
OBJECTIVE
Phenotypic heterogeneity in Tourette syndrome is partly due to complex genetic relationships among Tourette syndrome, obsessive-compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD). Identifying symptom-based endophenotypes across diagnoses may aid gene-finding efforts.
METHOD
Assessments for Tourette syndrome, OCD, and ADHD symptoms were conducted in a discovery sample of 3,494 individuals recruited for genetic studies. Symptom-level factor and latent class analyses were conducted in Tourette syndrome families and replicated in an independent sample of 882 individuals. Classes were characterized by comorbidity rates and proportion of parents included. Heritability and polygenic load associated with Tourette syndrome, OCD, and ADHD were estimated.
RESULTS
The authors identified two cross-disorder symptom-based phenotypes across analyses: symmetry (symmetry, evening up, checking obsessions; ordering, arranging, counting, writing-rewriting compulsions, repetitive writing tics) and disinhibition (uttering syllables/words, echolalia/palilalia, coprolalia/copropraxia, and obsessive urges to offend/mutilate/be destructive). Heritability estimates for both endophenotypes were high and statistically significant (disinhibition factor=0.35, SE=0.03; symmetry factor=0.39, SE=0.03; symmetry class=0.38, SE=0.10). Mothers of Tourette syndrome probands had high rates of symmetry (49%) but not disinhibition (5%). Polygenic risk scores derived from a Tourette syndrome genome-wide association study (GWAS) were significantly associated with symmetry, while risk scores derived from an OCD GWAS were not. OCD polygenic risk scores were significantly associated with disinhibition, while Tourette syndrome and ADHD risk scores were not.
CONCLUSIONS
The analyses identified two heritable endophenotypes related to Tourette syndrome that cross traditional diagnostic boundaries. The symmetry phenotype correlated with Tourette syndrome polygenic load and was present in otherwise Tourette-unaffected mothers, suggesting that this phenotype may reflect additional Tourette syndrome (rather than OCD) genetic liability that is not captured by traditional DSM-based diagnoses.
Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Child; Child of Impaired Parents; Child, Preschool; Comorbidity; Endophenotypes; Female; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Male; Middle Aged; Mothers; Multifactorial Inheritance; Obsessive-Compulsive Disorder; Phenotype; Risk Assessment; Tourette Syndrome; Young Adult
PubMed: 27809572
DOI: 10.1176/appi.ajp.2016.16020240 -
World Journal of Psychiatry Jul 2022Tourette syndrome (TS) is a complex neurodevelopmental condition marked by tics, as well as a variety of psychiatric comorbidities, such as obsessive-compulsive...
BACKGROUND
Tourette syndrome (TS) is a complex neurodevelopmental condition marked by tics, as well as a variety of psychiatric comorbidities, such as obsessive-compulsive disorders (OCDs), attention deficit hyperactivity disorder (ADHD), anxiety, and self-injurious behavior. TS might progress to treatment-refractory Tourette syndrome (TRTS) in some patients. However, there is no confirmed evidence in pediatric patients with TRTS.
AIM
To investigate the clinical characteristics of TRTS in a Chinese pediatric sample.
METHODS
A total of 126 pediatric patients aged 6-12 years with TS were identified, including 64 TRTS and 62 non-TRTS patients. The Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale (PUTS), and Child Behavior Checklist (CBCL) were used to assess these two groups and compared the difference between the TRTS and non-TRTS patients.
RESULTS
When compared with the non-TRTS group, we found that the age of onset for TRTS was younger ( < 0.001), and the duration of illness was longer ( < 0.001). TRTS was more often caused by psychosocial ( < 0.001) than physiological factors, and coprolalia and inappropriate parenting style were more often present in the TRTS group ( < 0.001). The TRTS group showed a higher level of premonitory urge ( < 0.001), a lower intelligence quotient (IQ) ( < 0.001), and a higher percentage of family history of TS. The TRTS patients demonstrated more problems ( < 0.01) in the "Uncommunicative", "Obsessive-Compulsive", "Social-Withdrawal", "Hyperactive", "Aggressive", and "Delinquent" subscales in the boys group, and "Social-Withdrawal" ( = 0.02) subscale in the girls group.
CONCLUSION
Pediatric TRTS might show an earlier age of onset age, longer duration of illness, lower IQ, higher premonitory urge, and higher comorbidities with ADHD-related symptoms and OCD-related symptoms. We need to pay more attention to the social communication deficits of TRTS.
PubMed: 36051602
DOI: 10.5498/wjp.v12.i7.958