JUST RIGHT PERCEPTIONS ASSOCIATED WITH COMPULSIVE BEHAVIOR IN TOURETTES-SYNDROME

Objective: Tourette's syndrome is a chronic disorder of childhood onse t that is characterized by motor and phonic ties and a broad range of associated behavior including obsessive-compulsive symptoms. Less well appreciated are the sensory and other perceptually tinged mental phen omena associated with both tic and compulsive behavior. This cross-sec tional study evaluated the ''just-right'' phenomena commonly associate d with compulsive behavior in subjects with tic disorders. Method: A t otal of 134 subjects with tic disorders, aged 9 to 71 years, completed a questionnaire concerning their current and east tic symptoms. Subje cts were also asked to describe their ''just right'' perceptions. The Yale-Brown Obsessive Compulsive Scale was used to assess severity of c urrent obsessive-compulsive symptoms. Results: Eighty-one percent of t he subjects with both Tourette's syndrome and obsessive-compulsive dis order (N=31) and 56% of the subjects with Tourette's syndrome and obse ssive-compulsive symptoms (N=61) reported being aware of a need to per form compulsions until they were ''just right. '' This awareness most commonly referred to visual or tactile (as opposed to auditory/ featur es of the compulsive act or its consequences. Three-quarters of the su bjects with these perceptions reported that they usually were aware of them immediately before or concurrently with the initiation of compul sions. Conclusions: While epidemiological studies of tic disorders and obsessive-compulsive disorder have yet to incorporate questions conce rning ''just right'' perceptions, these results suggest that such perc eptions may be commonplace in adolescent and adult subjects with both obsessive-compulsive disorder and tic disorders. They also implicate b rain regions involved in the processing of sensorimotor information in the pathobiology of tic disorders.