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Tourette’s disorder (TD), also known as Tourette syndrome, is a fascinating yet complex neurodevelopmental disorder that can be challenging to treat. Dr. Georges Gilles de la Tourette, a French neurologist who described the first nine cases in 1885, had it right when he described the “peculiar” symptoms as a syndrome, later reporting that “fears, phobias, and arithmomania” were part of the picture.

Dr. Greenberg works in the obsessive compulsive disorder (OCD) and related disorders program, and I see both kids with tics and OCD or OCD-related disorders as well as those with symptoms consistent with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) or pediatric acute-onset neuropsychiatric syndrome (PANS). She typically sees two to three new patients a week who fit somewhere in the OCD, tic, or PANDAS spectrum.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits.

After reading these articles, you should be able to…

Clinicians used to say, “Oh, autism is very clear. It’s the one true disorder in child psychiatry.” Now we realize that there’s a spectrum, which makes some sense, especially from a broad evolutionary perspective: If these changes were totally maladaptive, they presumably would have been lost over time; instead, they’ve persisted. That suggests that, for some people, some other combinations of these genes must be somewhat or even quite adaptive.

In November 2016, the FDA announced that it was requiring two companies to withdraw their generic versions of Concerta (OROS methylphenidate) because of efficacy concerns. Such actions are quite unusual, and when they occur, they tend to shake doctors’ confidence in the generic drug system—which branded drug companies are often eager to encourage. But the Concerta case is hardly an indictment of generic drugs, or even of generic stimulants. Let’s dig a little deeper for some insight into the generic drug process.

Study Reviewed: Lenhard F et al. Therapist-guided, Internet-delivered cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: A randomized controlled trial. J Am Acad Child Adolesc Psychiatry 2017;56(1):10–19. doi:10.1016/j.jaac.2016.09.515