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Differentiation of chronic motor or vocal tic disorder: DSM-5 added a specifier to distinguish between vocal and motor tics that are chronic. This distinction was added because higher rates of comorbid diagnoses are present with vocal tics relative to motor tics. [16]
Among those with an older age of onset, more substance abuse and mood disorders are found, and there may be self-injurious tics. Adults who have severe, often treatment-resistant tics are more likely to also have mood disorders and OCD. [47] Coprolalia is more likely in people with severe tics plus multiple comorbid conditions. [32]
Knowledge, education and understanding are uppermost in management plans for tic disorders, [6] and psychoeducation is the first step. [14] [15] A child's parents are typically the first to notice their tics; [16] they may feel worried, imagine that they are somehow responsible, or feel burdened by misinformation about Tourette's. [14]
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Motor tics are movement-based tics affecting discrete muscle groups. [4]Phonic tics are involuntary sounds produced by moving air through the nose, mouth, or throat. They may be alternately referred to as verbal tics or vocal tics, but most diagnosticians prefer the term phonic tics to reflect the notion that the vocal cords are not involved in all tics that produce sound.
Comprehensive Behavioral Intervention for Tics (CBIT), based on HRT, is a first-line treatment for Tourette syndrome and tic disorders. [10] [11] With a high level of confidence, CBIT has been shown to be more likely to lead to a reduction in tics than other supportive therapies or psychoeducation. [12]
Specific treatment options for reliving motor and phonic tics (coprolalia) in Gilles de la Tourette syndrome include but are not limited to Botulinum toxin injections, antipsychotics or behavioral therapy depending on the individual's severity of symptoms.
Treatment of tics present in conditions such as Tourette's syndrome begins with patient, relative, teacher and peer education about the presentation of the tics. Sometimes, pharmacological treatment is unnecessary and tics can be reduced by behavioral therapy such as habit-reversal therapy and/or counseling. Often this route of treatment is ...