There are common neuropsychiatric conditions that occur in childhood. Such may include tic disorder (TD) and obsessive-compulsive disorder (OCD). These illnesses are highly comorbid as there are 30% of patients with OCD have been reported to have a lifetime history related to tics, while 50% of those with TD have been reported to have a lifetime history related to OCD.
Key Points for Tourettic OCD
- As a unique variety of OCD, tourettic OCD represents a combination of obsessive-compulsive and tics symptoms that may pose challenges to treatment, conceptualization and assessment.
- Impulsions are found to be different from classic obsessions and compulsions and simple tics in some very essential ways.
- Treatment for tourettic OCD includes exposure and response prevention, but it can also improve the results when incorporated with habit reversal training elements.
Characteristics of OCD
- A person suffering from OCD often experience intrusive, persistent and recurrent thoughts, urges, and images causing distress and anxiety.
- This is also accompanied by covert or overt goal-directed recurrent behaviors of the person feeling compelled to perform in accordance to rigid rules aimed to reduce anxiety or prevent some unwanted outcome.
Characteristics of TD
- Patients with TD experience non-rhythmic, rapid, and repetitive motor and vocal tics.
- Many people with TD are reported to have focal sensory phenomena before the tics and fades when the tic is done.
- Despite the distinction between TD and OCD, these disorders sometimes share some features making them hard to determine.
Characteristics of Tourettic OCD
- Persons suffering from tourettic OCD show symptom profiles that are varied from tic-free OCD. This means that patients with TOCD are less likely to have obsessions and compulsions that relate to checking, cleaning, and contamination compared to those with tic-free OCD.
- Moreover, they are more likely engaged to show tic-like impulsions, including tapping, touching, and rubbing behaviors in relation to feelings or thoughts of exactness and symmetry.
- Despite the fact that the main feature of TOCD involves impulsions, it is still inconsistent and uncertain on the basis of TD and OCD literatures.
- Although impulsions have some common characteristics with obsessions and compulsions, they are rarely done to lessen the anxious arousal and they lack cognitive and goal-directedness that are typical in tic-free OCD.
- Impulsions are not found to be a complex condition for OCD-related rituals or tics. However, this can pose some challenges to clinical assessments. Hence, there are efficient non-pharmacological involvement for the treatment of OCD and TD symptoms. Consequently, these are the main protocols that can be utilized to treat unique symptoms of tourettic OCD.
Challenges in Treatment Delivery
- The problems commonly encountered in the delivery of treatment of TOCD include motivation and compliance. Likewise, it requires a lot of effort in between sessions to deal with behavioral interventions, which poses a challenge for parents and the children involved.
- Parents may also have a difficult time when children are required to undergo distress during treatment.
- This may even lead to the parental accommodation of the symptoms which include avoiding contact with some triggers of TOCD, distracting or comforting the child undergoing exposure exercise, and modifying the daily routine of the child in order to lessen the impact of overall distress.