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Phenomenological differences appearing with repetitive behaviours in obsessive-compulsive disorder and Gilles de la Tourette's syndrome

Published online by Cambridge University Press:  03 January 2018

Euripedes C. Miguel*
Affiliation:
Department of Psychiatry, University of Säo Paulo Medical School, Säo Paulo, SP, Brazil, and Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Lee Baer
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Barbara J. Coffey
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA and McLean Hospital, Belmont, MA, Harvard Medical School, Boston, MA
Scott L. Rauch
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Cary R. Savage
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Richard L. O'Sullivan
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
Katharine Phillips
Affiliation:
Butler Hospital and Department of Psychiatry and Human Behaviour, Brown University School of Medicine, Providence (RI)
Cara Moretti
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
James F. Leckman
Affiliation:
Child Study Center, Yale University, New Haven, CT
Michael A. Jenike
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA
*
Euripedes C. Miguel, Instituto de Psiquiatria do Hospital das Clinicas da Falculdade de Medicina da USP, Rua Ovidio Pires de Campos s/no. São Paulo SR, CEP: 05430-010, Brasil, e-mail: ECMIGUEL@USP.BR; Fax: 011-280-0842

Abstract

Background

Obsessive–compulsive disorder (OCD) is heterogeneous, with some forms related to Gilles de la Tourette's syndrome (GTS). This is a phenomenological study designed to investigate the nature of these possible OCD subtypes and the relationship between OCD and GTS.

Method

We evaluated 20 adult outpatients with OCD, 21 with GTS, and 20 with OCD plus GTS using a semi-structured interview designed to assess cognitive, sensory and autonomic phenomena preceding repetitive behaviours.

Results

More cognitions and autonomic anxiety and fewer sensory phenomena were reported in OCD than in GTS. Like the GTS group, the OCD plus GTS group reported more sensory phenomena and fewer cognitions than the OCD group.

Conclusions

The presence or absence of cognitions, sensory phenomena, and autonomic anxiety distinguishes repetitive behaviours in patients with OCD from those with OCD plus GTS, and GTS. These subjective experiences may be useful in subtyping OCD and may represent valid predictors of prognosis and treatment response.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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