Repetitive behaviors in Tourette's syndrome and OCD with and without ties:what are the differences?

Gilles de la Tourette Syndrome (GTS) and obsessive-compulsive disorder (OCD ) share obsessive-compulsive phenomena. The aims of this study were to comp are the OC symptom distribution between GTS and OCD and to investigate whet her a subdivision of these phenomena into obsessions, compulsions and 'impu lsions' is useful in distinguishing CTS and OCD patients. Thirty-two GTS, 3 1 OCD (10 with ties, 21 without ties) and 29 control subjects were studied using the Leiden repetitive behaviors semi-structured interview to assess G TS as well as OCD-related behaviors. Each reported repetitive thought or ac tion was evaluated on the presence of anxiety and on goal-directedness, Thi s information was used to define whether the behavior was an obsession, com pulsion, or 'impulsion'. Both the GTS and OCD study groups showed higher sc ores than control subjects on rating scales measuring depression, OC behavi or and anxiety. In GTS, Y-BOCS severity scores and trait anxiety were lower than in the OCD groups. Furthermore, GTS patients differed from OCD patien ts in the distribution of symptoms. Aggressive repetitive thoughts, contami nation worries and washing behaviors were reported more frequently by tie-f ree OCD, while mental play, echophenomena, touching and (self)-injurious be haviors were reported more frequently by GTS. OCD individuals with ties wer e intermediate, but closer to tic-free OCD. GTS individuals reported signif icantly more 'impulsions' and fewer obsessions and compulsions than OCD ind ividuals with and without ties. Factor analysis revealed three factors acco unting for 44% of the variance, resulting in an 'impulsive' factor related to GTS, a 'compulsive' factor related to OCD and an 'obsessive' factor rela ted to tic-free OCD. In conclusion, OCD individuals reported more anxiety a nd goal-directedness associated with their behaviors than did GTS subjects. The distinction between obsessions, compulsions and impulsions is of impor tance in identifying Tourette-related vs. non-Tourette-related repetitions. (C) 2001 Elsevier Science Ireland Ltd. All rights: reserved.