Click here to download

Tic or OCD? That is a question
Author/s: Monica Mercuriu, Carlo Buonanno 
Year:  2017 Issue: 41 Language: Italian 
Pages:  14 Pg. 53-66 FullText PDF:  149 KB
DOI:  10.3280/QPC2017-041004
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 

Tic disorders and Tourette Syndrome (TS) have a high degree of comorbidity with Obsessive Compulsive Disorder (OCD) and Attention Deficit Hyperactivity Disorder (ADHD), conditions that may precede or appear after the tic manifestation in the child. TS and OCD comorbidity is bidirectional, 23% of TS patients meet the criteria for OCD; between 7 and 37% of individuals with OCD can also meet the criteria for TS (Miguel et al., 2001). In children and adults with TS and OCD, the most common symptomatic behaviors are control, order and symptom rituals, with low percentages of washings based on contamination concerns (Hanna et al., 2002; Leckman et al., 2000; Mansueto and Keuler, 2005). In children with TS who exhibit comorbidity with DOC it is not always possible to trace the presence of obsessive thoughts, there are more rituals and compulsive behaviors; More-over, some complex tics, due to their phenomenological aspect, can be exchanged for compulsions, and this aspect, coupled with the complexity of the symptomatic framework, often makes it difficult to implement targeted and effective treatment. In this paper, a 13-year-old patient, David, who has a Tourette Syndrome diagnosis in comorbid OCD, school phobia, and depressive symptoms, will be exposed. The rationale for the intervention, the strategies used and the outcomes of the therapy will be exposed.
Keywords: Tourette Syndrome, chronic tic disorders, exposure with response prevention, obsessive compulsive disorder.

  1. Achenbach T.M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington, VT: University of Vermont Press.
  2. Bliss J. (1980). Sensory experiences of Gilles de la Tourette syndrome. Archives of General Psychiatry, 37(12): 1343-1347.
  3. Bruun R., Budman C. (1997). The course and prognosis of Tourette syndrome. In: Jankovic J. (ed.), Tourette Syndrome: Neurologic Clinics. Philadelphia: Saunders, pp. 291-298.
  4. Buonanno C., Perdighe C., Mancini F. (2009). La psicoterapia del disturbo ossessivo compulsivo in età evolutiva. Giornale Italiano di Neuropsichiatria Infantile, 29, 3: 290-308.
  5. Coles M.E., Frost R.O., Heimberg R.G., Rhéaume J. (2003). “Not just right experiences”: perfectionism, obsessive-compulsive features and general psychopathology. Behaviour Research and Therapy, 41: 6: 681-700., DOI: 10.1016/S0005-7967(02)00044-
  6. Freeman R.D., Fast D.K., Burd L., Kerbeshian J., Robertson M.M., Sandor P. (2000). An international perspective on Tourette syndrome: selected findings from 3.500 individuals in 22 countries, Developmental Medicine e Child Neu-rology, 42, 7: 436-447.
  7. Hanna G.L., Piacentini J., Cantwell D., Fischer D., Himle J., Van Etten M. (2002). Obsessive-compulsive disorder with and without tics in a clinical sample of children and adolescents. Depression and Anxiety, 16: 59-63.
  8. Himle M.B., Woods D.W., Piacentini J.C., Walkup J.T. (2006). Brief review of habit reversal training for Tourette syndrome. Journal of Child Neurology, 21: 719- 725., DOI: 10.2310/7010.2006.0015
  9. Jenike M.A. (2001). An update on obsessive-compulsive disorder. Bulletin of the Menninger Clinic, 65: 4-25.
  10. Leckman J.F., Cohen D.J. (eds.) (1999). Tourette’s syndrome – Tics, obsessions, compulsions: Developmental psychopathology and clinical care. New York: Wiley., DOI: 10.1016/S0140-6736(02)11526-
  11. Leckman J.F., Walker D.E., Cohen D.J. (1993). Premonitory urges in Tourette’s syndrome. American Journal of Psychiatry, 150: 98-102. PsycINFO Database Record (c) 2012 APA.
  12. Mancini F., Gangemi A., Perdighe C., Marini C. (2008). Not Just Right Experience: Is it influenced by guilt emotion? Journal of Behavior Therapy and Experi-mental Psychiatry, 39, 2: 162-176.
  13. Mansueto C.S., Keuler D.J. (2005). Tic or compulsion? It’s Tourettic OCD. Behavior Modification, 29, 5: 784-799., DOI: 10.1177/014544550527926
  14. Miguel E.C., do Rosario-Campos M.C., Prado H.D., Valle R., Rauch S.L., Coffey B.J. et al. (2000). Sensory phenomena in obsessive-compulsive disorder and Tourette’s disorder. Journal of Clinical Psychiatry, 61: 150-156.
  15. Shapiro A.K., Shapiro E. (1984). Controlled study of pimozide vs. placebo in Tourette’s syndrome, Journal of the American Academy of Child Psychiatry, 23, 2: 161-173.
  16. Spessot A.L., Peterson B.S. (2006). Tourette’s syndrome: A multifactorial, developmental psychopathology. In: Cicchetti D., Cohen D.J. (eds.), Developmental psychopathology: Vol 3. Risk, disorder, and adaptation. Hoboken, NJ: Wiley, 2nd ed., pp. 436-469. In: Woods D.W., Piacentini J., Walkup J.T. (2007), Treat-ing Tourette Syndrome and Tic Disorders: A Guide for Practitioners. New York: Guilford Press.
  17. Woods D., Piacentini J., Himle M., Chang S. (2005). Initial development and psychometric properties of the Premonitory Urge for Tics Scale (PUTS) in children with Tourette syndrome. Journal of Developmental and Behavioral Pediatrics, 26: 1-7.
  18. Woods D.W., Hook S.T., Spellman D., Friman P. (2000). Case study: Exposure and response prevention for an adolescent with Tourette’s syndrome and OCD. Journal of American and Child Adolescent Psychiatry, 39: 904-907., DOI: 10.1097/00004583-2200007000-0002
  19. Zohar A.H., Apter A., King R.A., Pauls D.L., Jeckman J.F., Cohen D.J. (1999). Epidemiological studies. In: Leckman J.F., Cohen D.J. (eds.), Tourette’s syndrome – Tics, obsessions, compulsions: Developmental pathology and clinical care. New York: Wiley, pp. 177-193., DOI: 10.1016/S0387-7604(03)90004-

Monica Mercuriu, Carlo Buonanno, Tic or OCD? That is a question in "QUADERNI DI PSICOTERAPIA COGNITIVA" 41/2017, pp. 53-66, DOI:10.3280/QPC2017-041004


FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content