What are the obsessive-compulsive symptoms of Tourette syndrome (TS) and other tic disorders?

Updated: May 30, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
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Answer

Obsessions are unwanted repetitive thoughts, fears, or mental images, eg, "I better do that over again until it looks right." Compulsions are actions, generally perceived as volitional but irresistible, performed repeatedly to reduce obsessive worries or according to rigid rules. Common compulsions are counting, checking, straightening, hoarding, or grooming. Phenomenologically, obsessions and compulsions share many features with tics, and historically, some authors have referred to them as mental tics or psychic tics.

Obsessions and compulsions occur in tic patients about 20 times more commonly than in the general population. In many cases, symptoms meet DSM-IV criteria for OCD. Relatives also have markedly elevated rates of obsessions and compulsions, with or without tics. Conversely, relatives of children with OCD have high rates of TS whether or not the proband has TS. [152, 153] These facts support the view that obsessive-compulsive symptoms, like tics, are part of the natural TS phenotype rather than a comorbid second illness. [154, 108]

Findings such as those just described may suggest useful avenues for research into the treatment of tics. On the other hand, the observation that purely symptomatic therapies may treat 1 symptom but not the other makes sense if one accepts that they may be generated by different, but similarly affected, areas of the brain.


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