04-10-2009, 02:42 PM
A 17-year-old boy presents to an outpatient psychiatry clinic with the chief complaint of facial tics and verbal outbursts. He reports that he experienced his first tic at 5 years of age, when he developed a repetitive nonrhythmic throat clearing in response to the persistent sensation that he had an unrelieved itch in the back of his throat. By 7 years of age, the throat-clearing persists, joined by forceful nasal exhalations and eye-blinking. As a teenager, he has all the old tics present together plus occasional bursts of shouted obscenities, racial slurs, and vulgarities that cause him great psychological distress as they often occur in the public setting. What is true of the verbal and motor tics that characterize this individual™s illness?
A. Increased frequency of tics occurs when patients are asleep
B. The majority of tics take the form of coprolalia (swearing or vulgarity)
C. There is a higher incidence of tics in females than males
D. There is a strong link between tics and obsessive-compulsive disorder (OCD)
E. Tics are exacerbated by use of dopaminergic agents
A. Increased frequency of tics occurs when patients are asleep
B. The majority of tics take the form of coprolalia (swearing or vulgarity)
C. There is a higher incidence of tics in females than males
D. There is a strong link between tics and obsessive-compulsive disorder (OCD)
E. Tics are exacerbated by use of dopaminergic agents