Tourette's disorder: nursing approach in a multidisciplinary psychiatric day hospital team

Abstract

Tourette's disorder (TD) is characterized by multiple motor tics and one or more vocal tics with onset before the age of 18, and is frequently associated with other neurobehavioural disorders such as obsessive-compulsive disorder (OCD), ADHD, self-injurious behaviour or depression. We present the case of a 24-year-old man with TD and OCD in treatment since the age of 14, with a history of school bullying, complex tics, compulsions and self-injurious behaviour (defenestration), who is readmitted to a psychiatric day hospital after a relapse due to treatment abandonment linked to his religious beliefs. After assessment according to Virginia Henderson’s needs model and the use of specific scales (Pittsburgh, Maudsley, Yale-Brown), NANDA diagnoses were formulated with NOC outcomes and NIC interventions (anxiety, self-mutilation, ineffective coping, readiness for enhanced sleep, obesity and readiness for enhanced knowledge), within a multidisciplinary approach (psychiatry, psychology, social work and occupational therapy). During admission the symptoms decreased, sleep and adherence improved, and the patient reoriented his academic expectations.