The treatment of Tourette's syndrome: multimodal, developmental intervention.
The increasing clinical recognition of milder phenotypic variants of Tourette's syndrome and the keener appreciation of its phenomenological continuity with other transient and chronic tic syndromes have required a greater comprehensiveness and sophistication in the assessment and management of the disorder. Treatment must be individualized based on considerations of the source and degree of functional impairment associated with tics, the current and future impairment associated with comorbid illnesses, the available internal and external sources of support and capacities for coping, and the challenges that the tics and comorbidities present at varying stages of development. Specific therapeutic interventions must target not only tic symptoms, but also comorbid illnesses and coping strategies that can profoundly influence the unique impact that tic symptoms may have on an individual's well being during childhood and adolescence, and later into adulthood.
Peterson
B S
BS
Yale Child Study Center, Yale School of Medicine, New Haven, Conn. 06520, USA.
Cohen
D J
DJ
D000223:Adaptation, Psychological; D000293:Adolescent; D000322:Adrenergic Agonists / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000628:therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003000:Clonidine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011613:Psychotherapy; D012944:Social Support; D005879:Tourette Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*
D000322:Adrenergic Agonists; D000929:Antidepressive Agents, Tricyclic; D000697:Central Nervous System Stimulants; D018491:Dopamine Agonists; D005473:Fluoxetine; D003000:Clonidine