TOURETTES DISORDER WITH AND WITHOUT OBSESSIVE-COMPULSIVE DISORDER IN ADULTS - ARE THEY DIFFERENT

Clinical research has documented a bidirectional overlap between Toure tte's disorder (TD) and obsessive-compulsive disorder (OCD) from famil ial-genetic, phenomenological, comorbidity, and natural history perspe ctives. Patients with Tourette's disorder plus obsessive-compulsive di sorder (TD+OCD), a putative subtype, share features of both. The purpo se of this exploratory study was to evaluate correlates of patients wi th TD, OCD, and TD+OCD to determine whether TD+OCD is a subtype of TD, OCD, or an additive form of both. Sixty-one subjects with TD, OCD, or TD+OCD were evaluated with the Structured Clinical Interview for DSM- III-R supplemented with additional modules. The three groups differed in the rates of bipolar disorder (p < .04), social phobia (p < .02), b ody dysmorphic disorder (p < .002), attention deficit hyperactivity di sorder (p < .03), and substance use disorders (p < .04). These finding s were accounted for by the elevated rates of the disorders in the TDOCD group compared with the TD and OCD groups. These finding are most consistent with the hypothesis that TD+OCD is a more severe disorder t han TD and OCD and may be more etiologically linked to TD than to OCD. These findings highlight the importance of assessment of the full spe ctrum of psychiatric comorbidity in patients with TD and OCD.