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Eddy CM. The Transdiagnostic Relevance of Self-Other Distinction to Psychiatry Spans Emotional, Cognitive and Motor Domains. Front Psychiatry 2022; 13:797952. [PMID: 35360118 PMCID: PMC8960177 DOI: 10.3389/fpsyt.2022.797952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/14/2022] [Indexed: 01/18/2023] Open
Abstract
Self-other distinction refers to the ability to distinguish between our own and other people's physical and mental states (actions, perceptions, emotions etc.). Both the right temporo-parietal junction and brain areas associated with the human mirror neuron system are likely to critically influence self-other distinction, given their respective contributions to theory of mind and embodied empathy. The degree of appropriate self-other distinction will vary according to the exact social situation, and how helpful it is to feel into, or remain detached from, another person's mental state. Indeed, the emotional resonance that we can share with others affords the gift of empathy, but over-sharing may pose a downside, leading to a range of difficulties from personal distress to paranoia, and perhaps even motor tics and compulsions. The aim of this perspective paper is to consider how evidence from behavioral and neurophysiological studies supports a role for problems with self-other distinction in a range of psychiatric symptoms spanning the emotional, cognitive and motor domains. The various signs and symptoms associated with problematic self-other distinction comprise both maladaptive and adaptive (compensatory) responses to dysfunction within a common underlying neuropsychological mechanism, compelling the adoption of more holistic transdiagnostic therapeutic approaches within Psychiatry.
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Affiliation(s)
- Clare M Eddy
- Birmingham and Solihull Mental Health NHS Foundation Trust, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Robertson MM, Eapen V, Rizzo R, Stern JS, Hartmann A. Gilles de la Tourette Syndrome: advice in the times of COVID-19. F1000Res 2020; 9:257. [PMID: 32411359 PMCID: PMC7195896 DOI: 10.12688/f1000research.23275.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 12/23/2022] Open
Abstract
The novel coronavirus disease (COVID-19) was identified as the cause of an outbreak of respiratory disease in China at the end of 2019. It then spread with enormous rapidity and by mid-March 2020 was declared a world pandemic. Gilles de la Tourette Syndrome (GTS) is a childhood-onset neurodevelopmental disorder with a worldwide prevalence of about 1% of the population. The clinical symptoms include multiple motor and one or more phonic (vocal) tics. Germane to this communication is that 85% of patients with GTS have associated psychiatric co-morbidities, many of which are being exacerbated in the current global health crisis. In addition, several symptoms of GTS may mimic COVID-19, such as a dry cough and sniffing (phonic tics), while other symptoms such as spitting, inappropriate touching of others and "non-obscene socially inappropriate symptoms" can potentially get patients with GTS into trouble with the law. We suggest that a clear explanation of the COVID-19 illness and GTS is important to enable colleagues of various specialities who tend to patients with GTS. It is important to acknowledge at the outset that the information available on the COVID-19 pandemic changes daily, including cases infected, deaths reported, and how various national health systems are planning and or coping or not. It is fair to say that having read the current medical and lay press we conclude that it is not easy to reassure our patients with absolute certainty. However, notwithstanding that, we hope our documentation is of some assistance.
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Affiliation(s)
- Mary M. Robertson
- Department of Psychiatry, University College of London, London, W1T-7NF, UK
| | - Valsamma Eapen
- University of New South Wales and Academic Unit of Child Psychiatry, Liverpool Hospital and Ingham Institute, Sydney, NSW 2170, Australia
| | - Renata Rizzo
- Section of Child and Adolescent Neuropsychiatry, University of Catania, Catania, Italy
| | - Jeremy S. Stern
- Department of Neurology, St George’s University of London, London, SW17 0QQ, UK
| | - Andreas Hartmann
- Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, 75013, France
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Robertson MM, Eapen V, Rizzo R, Stern JS, Hartmann A. Gilles de la Tourette Syndrome: advice in the times of COVID-19. F1000Res 2020; 9:257. [PMID: 32411359 PMCID: PMC7195896 DOI: 10.12688/f1000research.23275.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2020] [Indexed: 01/11/2024] Open
Abstract
The novel coronavirus disease (COVID-19) was identified as the cause of an outbreak of respiratory disease in China at the end of 2019. It then spread with enormous rapidity and by mid-March 2020 was declared a world pandemic. Gilles de la Tourette Syndrome (GTS) is a childhood-onset neurodevelopmental disorder with a worldwide prevalence of about 1% of the population. The clinical symptoms include multiple motor and one or more phonic (vocal) tics. Germane to this communication is that 85% of patients with GTS have associated psychiatric co-morbidities, many of which are being exacerbated in the current global health crisis. In addition, several symptoms of GTS may mimic COVID-19, such as a dry cough and sniffing (phonic tics), while other symptoms such as spitting, inappropriate touching of others and "non-obscene socially inappropriate symptoms" can potentially get patients with GTS into trouble with the law. We suggest that a clear explanation of the COVID-19 illness and GTS is important to enable colleagues of various specialities who tend to patients with GTS. It is important to acknowledge at the outset that the information available on the COVID-19 pandemic changes daily, including cases infected, deaths reported, and how various national health systems are planning and or coping or not. It is fair to say that having read the current medical and lay press we conclude that it is not easy to reassure our patients with absolute certainty. However, notwithstanding that, we hope our documentation is of some assistance.
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Affiliation(s)
- Mary M. Robertson
- Department of Psychiatry, University College of London, London, W1T-7NF, UK
| | - Valsamma Eapen
- University of New South Wales and Academic Unit of Child Psychiatry, Liverpool Hospital and Ingham Institute, Sydney, NSW 2170, Australia
| | - Renata Rizzo
- Section of Child and Adolescent Neuropsychiatry, University of Catania, Catania, Italy
| | - Jeremy S. Stern
- Department of Neurology, St George’s University of London, London, SW17 0QQ, UK
| | - Andreas Hartmann
- Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, 75013, France
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Ferreira GM, Zanini NV, de Menezes GB, Albertella L, Destree L, Fontenelle LF. When patients with OCD decide to seek, and not to avoid harm: The problem of suicidality in OCD. Bull Menninger Clin 2018; 82:360-374. [DOI: 10.1521/bumc.2018.82.4.360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a chronic, distressing, and disabling condition associated with a high risk of suicidal behavior and death by suicide. In this study, the authors describe two cases of OCD patients who developed recurrent suicidal behaviors in response to stressful life events that appeared to “confirm” their obsessive beliefs (termed “confirmatory events”). In both cases, the authors used accepted strategies for treating suicidality in other contexts (such as antidepressants, lithium, and electroconvulsive therapy), which proved unsuccessful. Future studies should investigate personalized strategies to treat suicidality and prevent suicide in OCD patients.
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Affiliation(s)
- Gabriela M. Ferreira
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Clinic Hospital of the Federal University of Paraná, Curitiba, Brazil
| | - Natalie V. Zanini
- Clinic Hospital of the Federal University of Paraná, Curitiba, Brazil
| | - Gabriela B. de Menezes
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Lucy Albertella
- Brain and Mental Health Research Hub, School of Psychological Sciences and the Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
| | - Louise Destree
- Brain and Mental Health Research Hub, School of Psychological Sciences and the Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
| | - Leonardo F. Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Brain and Mental Health Research Hub, School of Psychological Sciences and the Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
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Martino D, Madhusudan N, Zis P, Cavanna AE. An Introduction to the Clinical Phenomenology of Tourette Syndrome. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2013; 112:1-33. [DOI: 10.1016/b978-0-12-411546-0.00001-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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The psychopathological spectrum of Gilles de la Tourette syndrome. Neurosci Biobehav Rev 2012; 37:1008-15. [PMID: 23131314 DOI: 10.1016/j.neubiorev.2012.10.011] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Revised: 10/16/2012] [Accepted: 10/28/2012] [Indexed: 02/06/2023]
Abstract
Gilles de la Tourette syndrome (GTS) holds a unique status as quintessentially neuropsychiatric condition at the interface between neurology (movement disorder) and psychiatry (behavioural condition). This is a reflection of the common observation that the vast majority of patients present with behavioural problems in association with the motor and vocal tics which define GTS. The present article focuses on the relationship between GTS and obsessive-compulsive disorder (OCD), attention-deficit and hyperactivity disorder (ADHD), affective disorders (both major depression and bipolar affective disorder), and personality disorders. Over the last decade, converging lines of research have pointed towards the concept of a 'GTS spectrum', encompassing motor phenomena and behavioural symptoms, with important implications for the clinical management of patients.
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Thinning of the Motor–Cingulate–Insular Cortices in Siblings Concordant for Tourette Syndrome. Brain Topogr 2009; 22:176-84. [DOI: 10.1007/s10548-009-0105-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 07/13/2009] [Indexed: 10/20/2022]
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