The letter of Drs A. and E. Shapiro offers the opportunity for clarifying our findings concerning TS.
Each of the patients in our report satisfied the following DSM-III criteria for TS: multiple motor and phonic symptoms of over one year's duration, temporary suppressibility, and waxing and waning severity. In addition, the patients demonstrated characteristics of TS that have been highlighted since the first descriptions in the 19th century, including complex behaviors, echo phenomena, compulsions, obsessions, impulsivity, coprolalia, poor frustration tolerance, attentional difficulties, as well as school and learning proplems.1-4 For example, the Shapiros and colleagues found that 58% of their patients had minimal brain dysfunction and 57% had marked behavioral maladjustment.5 In the current letter, they state that the mental disorders of patients with TS are not statistically distinguishable from those of psychiatric outpatients, again suggesting the range and severity of psychiatric difficulties in patients with TS.
Cohen DJ, Detlor J, Young JG, Shaywitz BA. Clonidine and Haloperidol in Gilles de la Tourette Syndrome-Reply. Arch Gen Psychiatry. 1981;38(10):1184-1185. doi:10.1001/archpsyc.1981.01780350118016