Shim Se-Hoon, Kwon Young-Joon
Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea.
Clin Psychopharmacol Neurosci. 2014 Dec;12(3):235-9. doi: 10.9758/cpn.2014.12.3.235. Epub 2014 Dec 26.
Tourette syndrome consists of multiple motor tics and one or more vocal tics. Psychopathology occurs in approximately 90% of Tourette syndrome patients, with attention-deficit/hyperactivity, mood, and obsessive-compulsive disorders being common. Additionally, Tourette syndrome and bipolar disorder may be related in some individuals. However, it is unclear why bipolar disorder may be overrepresented in Tourette syndrome patients, and more research is needed. Herein, we report the case of a 15-year-old boy diagnosed with both Tourette syndrome and bipolar disorder, whose symptoms improved with aripiprazole, atomoxetine, and valproate. The patient was diagnosed with Tourette syndrome at 8 years of age when he developed tics and experienced his first depressive episode. The patient had a poor response to a variety of antidepressants and anti-tic medications. A combination of valproate and aripiprazole stabilized both the patient's tics and mood symptoms. It is important to assess individuals with Tourette syndrome for other disorders, including bipolar disorder. The treatment of children and adolescents with both Tourette syndrome and bipolar disorder is an important clinical issue.
抽动秽语综合征由多种运动性抽动和一种或多种发声性抽动组成。约90%的抽动秽语综合征患者会出现精神病理学症状,注意缺陷多动障碍、情绪障碍和强迫症较为常见。此外,在一些个体中,抽动秽语综合征与双相情感障碍可能存在关联。然而,尚不清楚为何双相情感障碍在抽动秽语综合征患者中更为常见,仍需更多研究。在此,我们报告一例15岁男孩,他同时被诊断患有抽动秽语综合征和双相情感障碍,其症状通过阿立哌唑、托莫西汀和丙戊酸盐得到改善。该患者8岁时出现抽动并经历首次抑郁发作,被诊断为抽动秽语综合征。患者对多种抗抑郁药和抗抽动药物反应不佳。丙戊酸盐和阿立哌唑联合使用使患者的抽动症状和情绪症状均得到稳定。对抽动秽语综合征患者进行包括双相情感障碍在内的其他疾病评估非常重要。治疗同时患有抽动秽语综合征和双相情感障碍的儿童和青少年是一个重要的临床问题。