Integrated Behavior Therapy in the Treatment of Complicated Tourette's Disorder and Its Comorbidities.

Gilles de la Tourette's syndrome (GTS) is a neuropsychiatric disorder that often presents with a complex array of motor and phonic tics that persist over the majority of a person's life. GTS often presents with comorbidities such as attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and mood disorders. Psychosocial sequelae are also common among this population. We present the case of a 49-year-old woman with severe, lifelong GTS complicated by OCD, inattention, impulsivity, disinhibition, mood disturbances, generalized anxiety, and pain secondary to motor tics. Habit reversal therapy (HRT) is used with full body relaxation conditioned as a competitive response to target her tics, anxiety, and pain simultaneously. The patient demonstrates significant reduction of symptoms and improvement in psychosocial status within four sessions. She is able to maintain this status at a 3-month follow-up session. Aspects of case conceptualization and therapeutic technique are discussed. [ABSTRACT FROM AUTHOR]