Tourette's Disorder with and without Obsessive-Compulsive Disorder in Adults: Are They Different?

Abstract

Clinical research has documented a bidirectional overlap between Tourette's disorder (TD) and obsessive-compulsive disorder (OCD) from familial-genetic, phenomenological, comorbidity, and natural history perspectives. Patients with Tourette's disorder plus obsessive-compulsive disorder (TD + OCD), a putative subtype, share features of both. The purpose of this exploratory study was to evaluate correlates of patients with TD, OCD, and TD + OCD to determine whether TD + OCD is a subtype of TD, OCD, or an additive form of both. Sixty-one subjects with TD, OCD, or TD + OCD were evaluated with the Structured Clinical Interview for DSM-III-R supplemented with additional modules. The three groups differed in the rates of bipolar disorder (p < .04), social phobia (p < .02), body dysmorphic disorder (p < .002), attention deficit hyperactivity disorder (p < .03), and substance use disorders (p < .04). These findings were accounted for by the elevated rates of the disorders in the TD + OCD group compared with the TD and OCD groups. These finding are most consistent with the hypothesis that TD + OCD is a more severe disorder than TD and OCD and may be more etiologically linked to TD than to OCD. These findings highlight the importance of assessment of the full spectrum of psychiatric comorbidity in patients with TD and OCD.

Influence of comorbid obsessive-compulsive symptoms on brain event-related potentials in Gilles de la Tourette syndrome

“…According to earlier studies, GTS+OCD represent a more severe phenotype, compared to pure GTS or OCD and appear to be more closely linked to GTS than OCD on the dimension of repetitive behavior (Cath et al, 2001) and other psychopathological comorbidity profile such as bipolar disorders, social phobia, body dismorphic disorders and attention deficit hyperactivity disorders (Coffey et al, 1998). Neuropsychological results obtained from a semantic Simon task revealed that the pure GTS and pure OCD groups were consistently disadvantaged in the more cognitively demanding conditions compared to matched controls (Rankins et al, 2006).…”

Obsessive-compulsive disorder phenotypes: implications for genetic studies

“…The rationale for this was based on data from previous clinical studies 22,65 indicating an association between TD and other OCD spectrum disorders such as body dysmorphic disorder and trichotillomania. Furthermore, there are consistent findings suggesting an association between TD and early OCD age of onset in the proband 21 and higher familial risk for OCD in their relatives.…”

“…Additional data suggest that hypochondria, 104 attention-deficit/hyperactivity disorder 65 and eating disorders 105 should also be considered as part of the OCD spectrum disorders constellation. The proposed model is graphically represented in Figure 1.…”

Deep Brain Stimulation for Psychiatric Disorders

“…There is some evidence that OCD and TS are related entities along a disease spectrum, and that the two disorders together are more severe than either one in isolation, which may eventually have implications with regard to patient and target selection. 19 Many investigators who study TS or OCS strive to find patients who have these disorders in isolation for scientific reasons, but this is often a challenge.…”