Peterson B S, Cohen D J
Yale Child Study Center, Yale School of Medicine, New Haven, Conn. 06520, USA.
J Clin Psychiatry. 1998;59 Suppl 1:62-72; discussion 73-4.
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.
随着对 Tourette 综合征较温和表型变异的临床认识不断增加，以及对其与其他短暂性和慢性抽动综合征现象学连续性的更深入理解，在该疾病的评估和管理方面需要更高的全面性和复杂性。治疗必须基于以下因素进行个体化：与抽动相关的功能损害的来源和程度、与共病相关的当前和未来损害、可用的内部和外部支持来源以及应对能力，以及抽动和共病在不同发育阶段所带来的挑战。具体的治疗干预不仅必须针对抽动症状，还必须针对共病以及应对策略，这些因素可能会深刻影响抽动症状在儿童期、青少年期以及成年后期对个体幸福感产生的独特影响。
