CHARACTERISTICS OF OBSESSIVE-COMPULSIVE SYMPTOMS IN TOURETTES-SYNDROME, OBSESSIVE-COMPULSIVE DISORDER, AND PARKINSONS-DISEASE

A high incidence of obsessions and compulsions is documented in basal ganglia disorders, especially in patients with Tourette's syndrome (TS ). A comparison of patients with obsessive-compulsive disorder (OCD), TS, and Parkinson's disease (PD) revealed significantly higher total s cores in both OCD and TS patients than in a healthy control group on t he Maudsley obsessive-compulsive inventory (MOCI) and the Hamburg obse ssive-compulsive inventory (HZI-K), two self-report measures of obsess ive-compulsive symptoms. On most subscales (especially Checking, Order ing, and Counting/touching), TS patients scored higher than controls. Patients with Parkinson's disease merely scored higher on the subscale 'Ordering' of the HZI-K. Differences between OCD patients and TS pati ents were evident on the MOCI subscales 'Checking' and 'Slowness/Repet ition' as well as on the MOCI total score and on the HZI subscales 'Cl eaning' and 'Obsessive Thoughts'. On these scales, TS patients reporte d fewer symptoms than OCD patients. Stepwise discriminant analysis wit h preselected single items as variables was used to look for specific symptom patterns of OCD and TS. Seventy-eight percent of the patients could be correctly classified with respect to their diagnoses on the b asis of only two items of the HZI-K. One item asks for fearful obsessi ve thoughts, which was found in 90% of the OCD patients; the second it em represented echo phenomena, found in 56% of the TS patients. It is concluded that considering specific patterns of obsessive-compulsive p sychopathology may contribute to a more reliable differential diagnosi s in OCD and TS and help to avoid misdiagnosis of OCD in TS patients. (C) 1997 Elsevier Science Ireland Ltd.