Disguised Tourette's syndrome. A contribution to the differential diagnosis on phobia and fear

Patients with Tourette's syndrome often develop multiple psychopathological symptoms beyond the basic symptoms (motor and vocal tics). We describe a female patient who had been treated over years with cognitive-behavioural methods under the diagnosis of anxiety disorder without success. Her obsessive-compulsive and tic symptoms had been ignored because they had not been reported by the patient, who was accustomed to them. Our case underlines the necessity of specific exploration and taking of a case history, especially when symptoms are atypical and do not improve under treatment. This gives cause for some critical remarks on the principle of comorbidity.