Division of Child and Adolescent Psychiatry, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, New York.
Ann N Y Acad Sci. 2013 Nov;1304:32-9. doi: 10.1111/nyas.12296. Epub 2013 Oct 31.
Competing theories on the etiology and treatment of chronic tic disorders and Tourette syndrome have long made the search for efficacious intervention more challenging for patients and families seeking to reduce functional impairment related to tic symptoms. These symptoms were historically posited to be either psychological in origin, leading to the long tradition of psychoanalytic psychotherapy for tics, or biological in nature, particularly since the advent of successful treatments using neuroleptic medications. Current thinking about the phenomenology of tic disorders comes from growing empirical evidence as well as advances in neuroscience and genetics research and reveals a biological vulnerability that is exacerbated by physiological arousal related to environmental or interpersonal stress. This manuscript summarizes the evolution of this knowledge base and describes current best-practice recommendations for patients, families, and clinicians.
长期以来，关于慢性抽动障碍和妥瑞氏综合征病因和治疗的各种理论，使得患者和家属在寻求减少与抽动症状相关的功能障碍时，更难以找到有效的干预措施。这些症状在历史上被认为要么是心理起源的，这导致了长期以来对抽动的精神分析心理疗法的传统，要么是生物学性质的，特别是自从使用神经阻滞剂药物成功治疗以来。目前对抽动障碍现象学的认识来自于越来越多的经验证据以及神经科学和遗传学研究的进展，揭示了一种生物学脆弱性，这种脆弱性会因与环境或人际压力有关的生理唤醒而加剧。本文总结了这一知识基础的演变，并描述了目前针对患者、家属和临床医生的最佳实践建议。
