Relations Between Tic Disorders and Obsessive-Compulsive Disorders


Unwanted urges and obsessions are burdensome because it likely interferes with daily life. These undesirable thoughts are associated with a lot of anxiety and distress over a specific event or action. Obsessive-Compulsive Disorder (OCD) is identified as intrusive and unwanted obsessions coupled with a compulsion or a sudden involuntary behavior. A tic disorder may often be characterized by motor or vocal. A vocal tic is when a person with the disorder will whistle, grunt, or repeat certain words. A motor tic is often exhibited through twitching, blinking, or nose scrunching. Obsessive-Compulsive Disorder and tic disorder can coexist, and the behaviors of each disorder can often overlap. 

There is a certain subtype of Obsessive-Compulsive Disorder, where many will identify as Tourettic Obsessive-Compulsive Disorder. This subtype is defined as extreme physical or psychological discomfort followed by a behavior that is carried out to relieve the discomfort. The difference between a tic and a behavior from Obsessive-Compulsive Disorder is very slight but can be correctly categorized by the intent. A tic can be characterized as a repetitive behavior that has no specific motive. Whereas a behavior from Obsessive-Compulsive Disorder is purposeful, and performed because it is believed to provide relief from discomfort. These distinctions are important especially in a clinical setting. It has been observed that when individuals with both these disorders seek treatment, they respond better when the treatment is catered to them rather than being treated for just one or the other. 

In a study led by Christine Conelea, it was proposed that children with tics in the Pediatric OCD Treatment Study II varied from those without tics. Therefore it is assumed that these children’s treatment responsiveness would differ because of a tic disorder. Youth between ages 7-17 with a primary diagnosis of Obsessive-Compulsive Disorder were included in this study. They were then divided into groups based on whether or not they had tics along with OCD or if they only had OCD without the presence of tics. This study used treatments like medication management, medication management plus instructions in cognitive behavioral therapy(CBT), or medication management plus full cognitive behavioral therapy. Throughout the treatment process people with tics terminated treatment early more often than people without tics did, however this was not reflective of how they responded to certain treatments. People with OCD and comorbid tics will benefit from cognitive behavioral therapy from someone with expertise in OCD and tic disorders. Tics are hypothesized to be facilitated by the feeling of relief when performing the behavior that alleviates discomfort. CBT aims to reduce the frequency of tics through exposure by purposely evoking more discomfort when that behavior is performed. 

The coexistence of both tic disorder and Obsessive-Compulsive Disorder does not suggest a higher degree of severity or a more intense expression of symptoms. Conelea’s study found that when comparing individuals with tic-related Obsessive Compulsive Disorder and individuals with only Obsessive-Compulsive Disorder, there was no significant difference in treatment responsiveness. Conelea’s study brings caution to making assumptions about people living with these disorders. 

 

References

Conelea, C. A., Walther, M. R., Freeman, J. B., Garcia, A. M., Sapyta, J., Khanna, M., & Franklin, M. (2014, December). Tic-related obsessive-compulsive disorder (OCD): Phenomenology and treatment outcome in the pediatric OCD treatment study II. Journal of the American Academy of Child and Adolescent Psychiatry. Retrieved October 16, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254546/.

Marla Deibler, P. D. (2020, October 12). What is “just right” OCD and tic-like compulsions? Verywell Mind. Retrieved October 16, 2021, from https://www.verywellmind.com/just-right-ocd-2510668. 

Obsessive-compulsive disorder and TIC disorders. Duke Health. (n.d.). Retrieved October 16, 2021, from https://www.dukehealth.org/treatments/child-psychiatry/ocd-and-tic-disorders.

Tics, Tourette syndrome, and OCD. HealthyChildren.org. (n.d.). Retrieved October 16, 2021, from https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Tics-Tourette-Syndrome-and-OCD.aspx.

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