coprolalia - Characteristics, Prevalence, Perception

The uncontrolled verbalization of obscenities. It occurs rarely in a variety of psychiatric disorders.

The term is often used as a clinomorphism, with 'compulsive profanity' inaccurately referred to as being Tourette syndrome.

Characteristics

Coprolalia encompasses words and phrases that are culturally taboo or generally unsuitable for acceptable social use, when used out of context.

Coprolalia is an occasional but rare 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.

Coprolalia is also a rare symptom of other psychiatric disorders, such as Lesch-Nyhan syndrome.

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. There is a paucity of epidemiological studies of Tourette syndrome; Studies on people with Tourette's often "came from tertiary referral samples, the sickest of the sick". 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, resulting in increased diagnoses of milder cases. 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. 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). A more recent Brazilian study of 44 patients with Tourette syndrome found a 14% rate of coprolalia; a Chilean study of 70 patients found a 8.5% rate of coprolalia; and a still older clinical study in Brasil found 28% of 32 patients had coprolalia. 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.

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.