Tourette’s Syndrome: Self-Injurious Behavior

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


Self-injurious behavior (SIB) refers to deliberate, nonaccidental, repetitive infliction of self-harm without suicidal intent. Although SIB is present in approximately 4% of general psychiatric patients, it occurs in up to 60% of patients with Tourette syndrome (TS). A variety of minor and major forms of SIB have been reported, including compulsive skin picking, lip biting, filing the teeth, head banging, self hitting, eye damage from self poking, self cutting, and even castration.

SIB is correlated with the severity of tic symptoms and with high levels of obsessiveness and hostility. Individuals with TS plus at least one other psychiatric morbidity have a fourfold increased risk of SIB. There is also a positive linear relationship between the number of psychiatric comorbidities and the presence of SIB.


Psychiatric Comorbidities Tourette Syndrome Emergency Room Visit Psychiatric Morbidity Positive Linear Relationship 
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Supplementary material

The patient has a towel wrapped around his hand in order to prevent injury. He exhibits violent episodes of hitting a wall and occasionally hitting himself. Some of the episodes are associated with violent shouting or screaming.

5 PD - Levodopa-induced dyskesia.mp4 (MP4 30,822KB)


  1. 1.
    Matthews CA, Waller J, Glidden DV, et al. Self injurious behaviour in Tourette syndrome: correlates with impulsivity and impulse control. J Neurol Neurosurg Psychiatry. 2004;75:1149–55.CrossRefGoogle Scholar
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    Robertson MM, Trimble MR, Lees AJ. Self-injurious behavior and the Gilles de la Tourtte syndrome: A clinical study and review of the literature. Psychol Med. 1989;19:611–25.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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