To: ts@tsa-usa.org, josephj@bcm.tmc.edu, fp@aafp.org, jwright@aafp.org, cormierb@psychiatry.wustl.edu, comments@nejm.org, jpearson@parkinson.org
I am writing because a misleading and stigmatizing representation of Tourette's syndrome was published recently in the New England Journal of Medicine. This inaccurate definition of Tourette's will hinder accurate diagnoses in family practice of patients with Tourette's. It further unnecessarily stigmatizes persons with Tourette's by inaccurately attaching "behavioral disturbances" as part of the diagnosis. It is surprising that the NEJM would allow publication of an article which has an error in the basic definition of the condition, particularly when there is ample research literature refuting the claims made by Joseph Jankovic, MD, in this article.
The current diagnostic criteria for Tourette's is listed here:
http://www.behavenet.com/capsules/disorders/touretteTR.htm
Diagnostic criteria for 307.23 Tourette's Disorder
A. Both multiple motor and one or more vocal tics have been present at some time during the illness.
B. The tics occur many times a day nearly every day or intermittently throughout a period of more than 1 year, and during this period there was never a tic-free period of more than 3 consecutive months.
C. The onset is before age 18 years.
D. The disturbance is not due to the direct physiological effects of a substance or a general medical condition.
The article in question is carried online by Washington University and the National Parkinsons Foundation at:
psychiatry.wustl.edu/Resources/LiteratureList/2001/November/Jankovic.pdf
and
http://www.parkinson.org/tourettesynd.htm
It includes a Venn diagram showing Tourette's to lie at the intersection of tics, ADHD, OCD, and behavioral disturbances, and stated the following:
"The diagnosis is based on the occurrence of tics along with behavioral disorders, including attention - deficit -- hyperactivity disorder (ADHD) and obsessive - compulsive disorder (OCD). Other behavioral disorders include anxiety and mood disorders, learning disorders, sleep disorders, conduct and oppositional behavior, and self-injurious behavior."
Jankovic J. Tourette's syndrome. New England Journal of Medicine, October 18, 2001; 345:1184-92.
This information is inaccurate: only tics are required for a diagnosis of Tourette's. I hope steps will be taken to rectify this inaccurate and unnecessary representation of persons with Tourette's syndrome.
Include your personal story here
Further information is included here:
http://tourettenowwhat.tripod.com/JankovicNEJM.htm
I am writing because a misleading and stigmatizing representation of Tourette's syndrome was published recently in the New England Journal of Medicine. This inaccurate definition of Tourette's will hinder accurate diagnoses in family practice of patients with Tourette's. It further unnecessarily stigmatizes persons with Tourette's by inaccurately attaching "behavioral disturbances" as part of the diagnosis. It is surprising that the NEJM would allow publication of an article which has an error in the basic definition of the condition, particularly when there is ample research literature refuting the claims made by Joseph Jankovic, MD, in this article.
The current diagnostic criteria for Tourette's is listed here:
http://www.behavenet.com/capsules/disorders/touretteTR.htm
Diagnostic criteria for 307.23 Tourette's Disorder
A. Both multiple motor and one or more vocal tics have been present at some time during the illness.
B. The tics occur many times a day nearly every day or intermittently throughout a period of more than 1 year, and during this period there was never a tic-free period of more than 3 consecutive months.
C. The onset is before age 18 years.
D. The disturbance is not due to the direct physiological effects of a substance or a general medical condition.
The article in question is carried online by Washington University and the National Parkinsons Foundation at:
psychiatry.wustl.edu/Resources/LiteratureList/2001/November/Jankovic.pdf
and
http://www.parkinson.org/tourettesynd.htm
It includes a Venn diagram showing Tourette's to lie at the intersection of tics, ADHD, OCD, and behavioral disturbances, and stated the following:
"The diagnosis is based on the occurrence of tics along with behavioral disorders, including attention - deficit -- hyperactivity disorder (ADHD) and obsessive - compulsive disorder (OCD). Other behavioral disorders include anxiety and mood disorders, learning disorders, sleep disorders, conduct and oppositional behavior, and self-injurious behavior."
Jankovic J. Tourette's syndrome. New England Journal of Medicine, October 18, 2001; 345:1184-92.
This information is inaccurate: only tics are required for a diagnosis of Tourette's. I hope steps will be taken to rectify this inaccurate and unnecessary representation of persons with Tourette's syndrome.
Include your personal story here
Further information is included here:
http://tourettenowwhat.tripod.com/JankovicNEJM.htm
