This week in Scientific American™ Medicine:
JUSTYNA R. SARNA, MD, PHD
Clinical Assistant Professor, Division of Neurology, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB
TAMARA PRINGSHEIM, MD, MSC
Assistant Professor, Division of Neurology, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB
Epidemiologic studies have emphasized the limitations of accurately studying the prevalence of tic disorders. Epidemiologic reports of the prevalence of obsessive-compulsive disorder (OCD) in Tourette syndrome (TS) vary greatly based on the definitions used and range from 10 to 35% to approximately 40%. Some studies have cited higher levels of comorbidity when including obsessive-compulsive symptoms without fulfilling disorder criteria. Interestingly, patients with comorbid OCD have a higher likelihood of complex tics at the initial presentation, which can further blur the distinction between tics versus compulsions in this cohort. Obsessive-compulsive symptoms may occur later compared with tic onset, and psychoeducation should emphasize this possibility. However, OCD associated with TS has earlier onset compared with OCD alone.
KOHEI HASEGAWA, MD, MPH
Assistant Professor, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
HAITHAM NSOUR, MBBS
ANNE E. DIXON, MA, BMBCH
Professor, Department of Medicine, University of Vermont College of Medicine, Fletcher Allen Health Care, Burlington, VT
Although researchers have evaluated the measures to increase primary care follow-up after the asthma-related emergency department (ED) visits, the results, so far, have been conflicting. Two randomized trials showed that facilitated referral of ED patients to the primary care providers did not alter long-term asthma outcomes. By contrast, Zeiger and colleagues demonstrated that referral of patients in the ED to an asthma specialist was associated with a lower risk of subsequent asthma-related ED visits.