Gilles de la Tourette's syndrome with and without obsessive-compulsive disorder compared with obsessive-compulsive disorder without tics: which symptoms discriminate?

J Nerv Ment Dis. 2001 Apr;189(4):219-28. doi: 10.1097/00005053-200104000-00003.

Abstract

Stereotyped repetitive behaviors occur in Gilles de la Tourette's Syndrome (GTS) and obsessive-compulsive disorder (OCD). The present study was undertaken to compare the distribution of obsessive-compulsive and Tourette-related impulsive behaviors in GTS with (+) OCD, GTS without (-) OCD, tic-free OCD, and control subjects. Fourteen GTS + OCD, 18 GTS-OCD, 21 OCD-tic, and 29 control subjects were evaluated using a semistructured interview designed to assess GTS and OCD-related repetitive behaviors. Each reported item was evaluated on the presence of anxiety and goal-directedness. This information was subsequently used to define whether the repetitive behavior was an (anxiety-related) obsession or compulsion, or a (non-anxiety-related) OC-like behavior, impulsion. GTS + OCD subjects reported more overall Tourette-related impulsions than OCD-tic subjects, i.e., more mental play, echophenomena, and touching behaviors but similar frequencies of typical obsessive-compulsive behaviors. Further, GTS + OCD subjects exhibited more overall repetitive behaviors than GTS-OCD subjects, i.e., more Tourette-related impulsions as well as more obsessive-compulsive behaviors. The distribution of symptoms is similar in GTS with and without OCD, and differs from tic-free OCD. These differences suggest that GTS with OCD constitutes a form of GTS, not of OCD, although the possibility that GTS + OCD patients constitute a subgroup distinct from GTS and from OCD can not be excluded by this phenomenological study. Specific non-anxiety-related impulsions seem to discriminate between GTS and OCD-tic individuals. These impulsions possibly reflect differences in underlying mechanisms between GTS and OCD-tics.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Comorbidity
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Obsessive-Compulsive Disorder / diagnosis*
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / psychology
  • Personality Inventory / statistics & numerical data
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Reproducibility of Results
  • Severity of Illness Index
  • Tics / diagnosis*
  • Tics / epidemiology
  • Tics / psychology
  • Tourette Syndrome / diagnosis*
  • Tourette Syndrome / epidemiology
  • Tourette Syndrome / psychology