Is there a relationship between Gilles de la Tourette and psychosis? A case report considering the continuum psychosis perspective and vulnerability model

Abstract

Introduction

There has been no evidence so far about significant relationship between Gilles de la Tourette and psychosis. Perhaps a continuum psychosis perspective and the vulnerability model could improve the comprehension of our patients.

Objectives

To describe a case in which motor and obsessive symptoms evolve to schizophreniform symptoms and important psychosocial deterioration.

Methods

Single case report and literature review.

Results

A 20-year-old man, with clinical record of Gilles de la Tourette, and a psychosis episode 6 months before, is brought by his family with a syndrome consistent in motor retardation, whispered speech, poor visual contact, social withdrawal, hygiene neglect, abulia, apathy and blunted affect. In the one-year tracing conceptual disorganization and poor idea association are in the first place. Within child history, we found symptoms congruent with Gilles de la Tourette, obsessive symptoms and others that may be called mild psychotic symptoms (which did not fit in any diagnosis at that moment). We also found a pathological relationship between his parents and among him, as well as a poor economic and social condition.

Conclusions

According to the continuum perspective, psychotic symptoms could be found within the obsessive spectrum. Related to the vulnerability model, we found in our case external factors that affected the clinical evolution: family dynamics affected, communication deviation, social and economic impairment, social withdrawal and vital aim loss. These factors should be attended in first place, as they are not only related with the triggering of illness but they also are the main way to recovery.

Disclosure of interest

The authors have not supplied their declaration of competing interest.