Tics and Tourette Syndrome: Key Clinical Perspectives

R. Freeman. Tics and Tourette Syndrome. Key Clinical Perspectives. London, UK: Mac Keith Press; 2015 (303 pages). ISBN: 978–1-909962–41–5. EUR ca 75.

This volume was written by a single author, Roger Freeman, Clinical Professor Emeritus, Department of Psychiatry, Children's Hospital Vancouver, Canada. Fifty years of clinical practice form the basis of this book. The volume is organized in 27 chapters, and has 7 appendices. It covers the whole spectrum relevant for daily practice (as Diagnosis and Definitions, Presentation to Clinicians, Prevalence and Epidemiology, Comorbid Disorders and Symptomatology, Stereotypic Movement Disorders, Intervention and Treatment).

The chapters include many case examples, usually with a specific comment. In addition, Dr. Freeman obviously likes to highlight his messages with numerous framed practice points. Reading of the text was demanding for me, as the style is somehow unconventional and despite the practice points the structure is “soft.” However, I am impressed by his attitude, his clinical empathetic and nuanced approach, as well as his interaction with parents and patients. The text includes a wealth of practical hints. No doubt evaluation and management of tics and Tourette syndrome are complex and challenging. Comorbidity is the rule, rather than the exception, often resulting in more impairment than do the tics themselves. Therefore, evaluation of these potential comorbidities must be a part of every assessment of a tic disorder. Dr. Freeman points to numerous mistakes and misconceptions. Do you know the difference between tics, stereotypic movement disorder, and stereotypes in autism spectrum disorder? You will find the answers in this text. I found one advice, particularly important: Find out what the person (parent) has already learned and why the question is important. Another point is well taken: Always seek to meet both parents for psychoeducation, if at all possible. Mothers become experts on their children, but fathers need to be included.

This book is a recommended reading for all who care for children and teenagers with tics and Tourette syndrome.