In detail

What do tics consist of and why do we have them?

What do tics consist of and why do we have them?

We all have our own movements and gestures, which are characteristic of each person. Certain cases are pathological, because it acquires significant dimensions affecting the person in different areas. Before entering the subject we will differentiate some important concepts with which they are often confused.

Content

  • 1 The stereotypes
  • 2 The symptomatic acts
  • 3 The mannerisms
  • 4 What are the Tics?
  • 5 Some examples of tics
  • 6 Statistics and prevalence
  • 7 Tics Disorders: Classifications
  • 8 Diagnosis

Stereotypes

It is called stereotyping to repeated and unnecessary repetition of an act that may appear in facial or body mimicry. In the psychotic patients Stereotypes are very spectacular. Two types are commonly distinguished by the complexity of their movements:

  • Simple: They often arise in chronic organic brain disorders of demential evolution as a sign of disintegration, for example: atrophies and atherosclerosis. Scratch, rub, slap on the knees, etc.
  • Complexes: They can indicate more psychic psychopathological disorders, such as hand movements, touching the hair, tinkering with objects, spinning, etc.

Tics must be distinguished from stereotyped movements, included in the stereotyped movement disorder.

Symptomatic acts

“They are those acts that men perform automatically and unconsciously, without realizing it, such as playing and those who deny all significance, declaring them indifferent and casual when they are interrogated about them, but a more careful observation shows that such acts of which the consciousness does not know or does not want to know anything, they externalize ideas or unconscious impulses, being very valuable and instructive as manifestations of the unconscious ”. Sigmund Freud

Stereotypes are sometimes confused with extrapyramidal disorders, which may be due to other diseases such as huntington's chorea, Parkinson's disease; appear more frequently in the clinic as side effects of antipsychotic medications, especially for prolonged treatments. Torsion crises of the neck, spasms of the mandibular musculature, the crisis of ocular deviation or stiffness and akinesia, when detected, can be treated with drugs capable of compensating and remitting the disorders.

The mannerisms

Are the parasitic movements that increase expressiveness of gestures and mimicry, they are intensified in psychotic pictures, they are identified as peculiarities, they can be: active indifference, effeminate or aristocratic postures, among others.

What are the Tics?

They are fast and jerky movements, they appear in the face, head and neck in a repetitive and involuntary way and seemingly meaningless, they can be fast and recurring, not rhythmic and stereotyped. Symptoms usually worsen in the face of emotional tension and stress.; they attenuate with distraction and disappear during sleep.

The attempt to voluntarily control the tics reaches produce many times unease and anxiety, which increases until the tic is repeated; some authors consider them as a ananastic phenomenon well remember the obsessive situation in front of their rituals. Clinically, the similarity with certain symptoms with post-encephalic symptoms such as vocal and motor tics is remarkable.

It is substantial to teach patients anxiety control techniques and stress, like breathing, relaxation exercises, as well as other tools that can serve as a resource to reduce anxiety, as well as promoting occupational therapy with an activity that the person likes such as reading, sewing or knitting, because the symptoms may decrease while the patient is absorbed performing an occupational type task.

Although they are considered involuntary, the one who suffers from them experiences prior tics tension, the patient is able to delay its appearance for a few seconds or even for hours, but in the end they are usually triggered with greater intensity and frequency.

Some examples of tics

Frowning, winking with your eyes, pulling your hair back, moving your neck as if something bothers you around it, are examples of some of the most common tics. It is worth mentioning that do not affect intelligence, although there are more obsessive tendencies. Obsessive tics are accompanied by an ideational component that does not exist in other types of tics.

Just before the tics occur, people with tics are generally aware of certain Premonitory and consummatory impulses can identify it as a perception focused on some part of the body.

Statistics and prevalence

Frequently They arise in childhood around 7 years and occurs more in men (4: 1); The most common initial manifestation is forced blinking. A third of the parents of children with tics have psychiatric disorders.

In most cases the symptom disappears in a period of a few months to 1 or 2 years, sometimes you can see residual disorders such as restlessness, anxiety and depression. There are intermediate forms that stop in adolescence. In a few cases, the symptom persists becoming chronic, which is more common in late-onset forms that begin in the fourth or fifth decade of life.

Tics Disorders: Classifications

The DSM-V (Manual of the Statistical Diagnosis of Mental Disorders) classifies the disorders of tics as follows:

  • Tourette disorder.
  • Disorders of chronic motor or vocal tics.
  • Disorder of transient tics.
  • Tics disorders not specified.

The ICD-10 (International Classification of Diseases) tells us that They can present themselves as isolated phenomena, but they usually go hand in hand with emotional disorders, categorizes them as:

  • Disorders of transient tics.
  • Disorders of chronic motor or tonic tics.
  • Disorder of multiple motor tics and plumbing combined (Tourette syndrome).
  • Residual Categories:
    • Other disorders of tics.
    • Disorder without specification.

Tourette disorder

It is characterized by the appearance of phonic, multiform, motor and changing tics, usually accompanied by other significant pathologies, it is one of the most severe tics disorders. It usually affects more affects men (3: 1), it often starts before 10 years of age, more specifically between 2 and 15 years of age.

It often starts in the form of monosymptomatic tic, then there is a progressive and oscillating inclusion of symptoms such as: massive contractions of the face, trunk, legs and rib cage, which can produce strange noises, in half of the cases there may be choreic movements (irregular, not predictable, change from one body area to another without a specific sequence); In extreme cases complex motor tics can be self-injurious like biting or hitting the face. The most serious cases contribute to the patient's life being seriously altered by the significant mismatches that it presents.

In adolescence, symptoms may occur more frequently and more abruptly.. When symptoms persist during adulthood, the disorders tend to be more maladaptive, since they affect academic, work and couple life, as it is related to emotional disturbances and both disruptive and aggressive behaviors, in some cases.

Other types of tics

TYPE OF ICTDESCRIPTION OR EXAMPLE

Single motors

Flashing, pursing your nose, lifting your shoulder, rotating your head, shaking your neck, making funny faces and coughing

Complex motors

They tend to appear intentional in character such as prancing, arm movements parodying a basketball goal, systematically touching certain objects or people, more marked facial gestures, gestures related to grooming, jumping, touching, trampling and sniffing objects.

Chronic or phonatory engines

Sometimes motor tics are presented and in other different sources the phonatories, they can be simple or more often multiple, they last more than a year.
Simple phonicsThey usually consist of screaming, throat clearing, loud inspirations, etc.

Complex phonics

Words and phrases of different meanings, but usually aggressive and coarse (coprolalia), repeated explosive vocalizations, among others.

Simple vowels

"Clear" throat, growl, inspire, snort, "bark."

Complex vowels

Repeat phrases or words out of context, such as coprolalia - use of socially unacceptable words, often obscene -, palilalia - repetition of one's own sounds or words - and ecolalia - repetition of the sound, of the word or phrase just heard -.

Chronic vowels

You can share the characteristics of complex and simple vowels but their duration is long.

Transitory

They do not persist more than a year, such as winks, facial faces or head shakes. They can include referrals and relapses.

Complexes

Like ecokinesia -imitation of the movements of another person-.
Not specifiedIt includes the disorders characterized by tics, but they do not meet a specific criterion.

Diagnosis

The difference between the conditions of these disorders must be based on personal history, history, observation and neurological exams along with the application of tests such as: the Global Gravity Scale of Yale tics, the Gravity Scale of Tourette syndrome and the Hopkins Vocal and Motor Tics Scale to establish a clear diagnosis, as They are easily confused with stereotypes and obsessive-compulsive behaviors.

Conclusions

It is convenient to take into account the psychodynamic and behavioral interpretations that may be useful for the treatment of the patient with tic disorder. The association of tics, hyperactivity, attention deficit and compulsions they generate a series of behavioral alterations that have their fundamental manifestation in conflicts family, and in other areas where they develop, so it is necessary to promote social skills because, very frequently, the aggressiveness of the child is very evident, both verbal and physical, as well as emotional lability.

The cognitive behavioral therapy, it offers good results for the treatment of tics, however, when the patient has very severe crises, hospitalization is required. Psychologists can provide the patient with resources and strategies for stress and anxiety management, promote self-observation, breathing control techniques, in many cases require the support of psychotropic drugs; Because of the disruptive nature of the tics, it is important to teach the individual to develop social skills.

People who have a tic disorder are often stigmatized, which can be derived in dysthymia and others mood disorders, for the problems in adaptation in social interactions. It is necessary to sensitize the population to publicize this type of suffering, so that there are fewer myths generated by the ignorance of the nature of the tics and remember that the differences between us are what makes us unique.

Links

Bibliographic references

  • Heles, Robert E .; Yudofsky, Stuart; Talbott, John et al. Treaty of Psychiatry. Spain: Ancora, S.A.
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