The disaster was my fault!

We report the case of a child affected by Gilles de la Tourette syndrome and comorbid obsessive-compulsive disorder who claimed to have caused the September 11, 2001 terrorist attacks in the United States by failing to accomplish a stereotyped compulsive ritual. Special attention is paid to the relationship between the patient's neuropsychiatric symptoms and the belief that he personally had influenced the outcome of an internationally notorious disaster. Prognostic and treatment implications are also presented, along with a review of the literature on the clinical and psychosocial impact of terrorist attacks and natural disasters on children suffering from neuropsychiatric disorders.