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14-September-2008 12:50:29 - Coprolalia Coprolalia is involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks. Coprolalia comes from the Greek κόπÏ?ος kopros meaning faeces and λαλία lalia meaning babbling, meaningless talk, from lalein, to talk.1 The term is often used as a clinomorphism, with 'compulsive profanity' inaccurately referred to as being Tourette syndrome. Related terms are copropraxia, performing obscene or forbidden gestures,2 and coprographia, making obscene writings or drawings.3 Contents 1 Characteristics 2 Prevalence 3 Treatment 4 Perception 5 References Characteristics Coprolalia encompasses words and phrases that are culturally taboo or generally unsuitable for acceptable social use, when used out of context. The term is not used to describe contextual swearing. It is usually expressed out of social or emotional context, and may be spoken in a louder tone or different cadence or pitch than normal conversation. It can be a single word, or complex phrases. A person with coprolalia may repeat the word mentally rather than saying it out loud; these subvocalizations can be very distressing.4 Coprolalia is an occasional characteristic of Tourette syndrome, although it is not required for a diagnosis of Tourette's. In Tourette syndrome, compulsive swearing can be uncontrollable and undesired by the person uttering the phrases. Involuntary outbursts, such as racial or ethnic slurs in the company of those most offended by such remarks, can be particularly embarrassing. The phrases uttered by a person with coprolalia do not necessarily reflect the thoughts or opinions of the person.4 Coprolalia is also a rare symptom of other psychiatric disorders,5 such as Lesch-Nyhan syndrome.6 Prevalence According to the Tourette Syndrome Association, fewer than 15% of Tourette syndrome patients exhibit coprolalia, but it tends to attract more attention than any other symptom.7 There is a paucity of epidemiological studies of Tourette syndrome; ascertainment bias affects clinical studies. Studies on people with Tourette's often came from tertiary referral samples, the sickest of the sick.8 Further, the criteria for a diagnosis of Tourette's were changed in 2000, when the impairment criteria was removed from the DSM-IV-TR for all tic disorders,9 resulting in increased diagnoses of milder cases. Further, many clinical studies suffer from small sample size. These factors combine to render older estimates of coprolalia-biased towards clinical populations of the more severe cases-outdated. An international, multi-site database of 3,500 individuals with Tourette syndrome drawn from clinical samples found 14% of patients with Tourette's accompanied by comorbid conditions had coprolalia, while only 6% of those with uncomplicated pure Tourette's had coprolalia. The same study found that the chance of having coprolalia increased linearly with the number of comorbid conditions: patients with four or five other conditions-in addition to tics-were four to six times more likely to have coprolalia than persons with only Tourette's.10 One study of a general pediatric practice found an 8% rate of coprolalia in children with Tourette syndrome, while another study found 60% in a tertiary referral center where typically more severe cases are referred.11 A more recent Brazilian study of 44 patients with Tourette syndrome found a 14% rate of coprolalia;12 a Costa Rican study of 85 subjects found 20% had coprolalia;13 a Chilean study of 70 patients found an 8.5% rate of coprolalia;14 older studies in Japan reported a 4% incidence of coprolalia;15 and a still older clinical study in Brazil found 28% of 32 patients had coprolalia.16 Considering the methodological issues affecting all of these reports, the consensus of the Tourette Syndrome Association is that the actual number is below 15 percent. Treatment Some patients have been treated by injecting botulinum toxin botox near the vocal cords. This does not prevent the vocalizations, but the partial paralysis that results helps to control the volume of any outbursts.171819 Surprisingly, botox injections result in more generalized relief of tics than the vocal relief expected.20 Perception The entertainment industry often depicts those with Tourette syndrome as being social misfits whose only tic is coprolalia, which has furthered stigmatization and the public's misunderstanding of those with Tourette's. The coprolalic symptoms of Tourette's are also fodder for radio and television talk shows.21 References ^ Coprolalia. Dictionary.com, Accessed 30 October 2006. ^ Schapiro NA. Dude, you don't have Tourette's: Tourette's syndrome, beyond the tics. Pediatr Nurs. 2002 May-Jun;283:243-6, 249-53. PMID 12087644 ^ Linguistics 210 Semantics pdf. Semantic features and Tourette's Syndrome. Retrieved on November 21, 2006. While this source defines coprographia, it makes misrepresentations about copro phenomena in relation to Tourette's: they are not common, and not required for diagnosis. ^ a b Cohen, J.E. and Levi-Pearl, S. Understanding Coprolalia - A misunderstood symptom. Available from the Tourette Syndrome Association, Accessed 30 October 2006. ^ Singer C. Tourette syndrome. Coprolalia and other coprophenomena. Neurol Clin. 1997 May;152:299-308. PMID 9115463 ^ Jinnah, HA. Lesch-Nyhan Syndrome. eMedicine.com August 29, 2006. Accessed 28 October 2006. ^ Tourette Syndrome Association. Tourette Syndrome FAQ. Accessed 6 October 2006. ^ Swerdlow, NR. Tourette Syndrome: Current Controversies and the Battlefield Landscape. Curr Neurol Neurosci Rep. 2005, 5:329-31. PMID 16131414 ^ What is DSM-IV-TR? Accessed 29 September 2006. ^ Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Dev Med Child Neurol. 2000 Jul;427:436-47. PMID 10972415 ^ Singer C. Tourette syndrome. Coprolalia and other coprophenomena. Neurol Clin. 1997 May;152:299-308. PMID 9115463 ^ Teive HA, Germiniani FM, Della Coletta MV, Werneck LC. Tics and Tourette syndrome: clinical evaluation of 44 cases. Arq Neuropsiquiatr. 2001 Sep;593-B:725-8. PMID 11593273 ^ Mathews CA, Herrera Amighetti LD, Lowe TL, van de Wetering BJ, Freimer NB, Reus VI. Cultural influences on diagnosis and perception of Tourette syndrome in Costa Rica. J Am Acad Child Adolesc Psychiatry. 2001 Apr;404:456-63. PMID 11314572 ^ Miranda M, Menendez P, David P, Troncoso M, Hernandez M, Chana P. Tics disease Gilles de la Tourette syndrome: clinical characteristics of 70 patients Rev Med Chil. 1999 Dec;12712:1480-6. Spanish. PMID 10835756 ^ Kano Y, Ohta M, Nagai Y. Tourette syndrome in Japan: a nationwide questionnaire survey of psychiatrists and pediatricians. Psychiatry Clin Neurosci. 1998 Aug;524:407-11. PMID 9766689 ^ Cardoso F, Veado CC, de Oliveira JT. A Brazilian cohort of patients with Tourette's syndrome. J Neurol Neurosurg Psychiatry. 1996 Feb;602:209-12. PMID 8708658 ^ Scott BL, Jankovic J, Donovan DT. Botulinum toxin injection into vocal cord in the treatment of malignant coprolalia associated with Tourette's syndrome. Mov Disord. 1996 Jul;114:431-3. PMID 8813224 ^ Jankovic J. Botulinum toxin in the treatment of dystonic tics. Mov Disord. 1994 May;93:347-9. PMID 8041378 ^ Kwak CH, Hanna PA, Jankovic J. Botulinum toxin in the treatment of tics. Arch Neurol. 2000 Aug;578:1190-3. PMID 10927800 ^ Stern JS, Burza S, Robertson MM. Gilles de la Tourette's syndrome and its impact in the UK. Postgraduate Medicine Journal. 2005 Jan;81951:12-9. PMID 15640424 Free full text available. ^ Tourette Syndrome Association. Oprah and Dr. Laura - Conflicting Messages on Tourette Syndrome. Oprah Educates; Dr. Laura Fosters Myth of TS as Cursing Disorder. May 31, 2001. Accessed 6 October 2001. Tourette Syndrome Association. Letter of response to Dr. Phil. Accessed 8 May 2006. Tourette Syndrome Association. Letter of response to Garrison Keillor radio show. Accessed 8 May 2006. Born, Matt. Tourette's man 'exploited by Big Brother' Accessed 22 May 2006. v d e Topics related to Tourette syndrome Main Causes and origins · History · Sociological and cultural aspects · Treatment Terms Coprolalia · Copropraxia · Echolalia · Echopraxia · Palilalia · Sensory phenomena · Tic · Tic disorder · Tourettism History Jean-Martin Charcot · Georges Gilles de la Tourette · Jean Marc Gaspard Itard · Arthur K. Shapiro Organizations Tourette Syndrome Association · Tourette Syndrome Foundation of Canada · Tourettes Action Media I Have Tourette's but Tourette's Doesn't Have Me · John's Not Mad · The Tic Code · Le Petit Tourette · Motherless Brooklyn Notable people Mahmoud Abdul-Rauf · Howard Ahmanson, Jr · Basshunter · Pete Bennett · Brad Cohen · Jim Eisenreich · Tim Howard · Samuel Johnson · Andre Malraux · Tobias Picker · Nick van Bloss · Michael Wolff Retrieved from http://en..org/wiki/Coprolalia Categories: Neurological disorders | Symptoms | Tourette syndrome Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages ÄŒesky Deutsch Español Français í•œêµì–´ Italiano Nederlands 日本語 Polski Português РуÑ?Ñ?кий Simple English Suomi Svenska This page was last modified on 7 September 2008, at 13
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