Am J Psychiatry 1993; 150:93-97
Copyright © 1993 by American Psychiatric Association
Obsessions in obsessive-compulsive disorder with and without Gilles de la Tourette's syndrome
MS George, MR Trimble, HA Ring, FR Sallee and MM Robertson
Raymond Way Neuropsychiatry Group, Institute of Neurology, London.
OBJECTIVE AND METHOD: Although obsessive-compulsive disorder commonly
occurs in many patients with Gilles de la Tourette's syndrome, little is
known about the obsessions and compulsions of Tourette's syndrome and
whether they differ from those seen in pure obsessive-compulsive disorder.
The authors prospectively studied 10 subjects with obsessive- compulsive
disorder and 15 subjects with obsessive-compulsive disorder and comorbid
Tourette's syndrome by using the Yale-Brown Obsessive Compulsive Scale, the
Leyton Obsessional Inventory, and a new questionnaire designed to emphasize
the differences in symptoms between these two groups. RESULTS: Subjects
with comorbid obsessive-compulsive disorder and Tourette's syndrome had
significantly more violent, sexual, and symmetrical obsessions and more
touching, blinking, counting, and self-damaging compulsions. The group with
obsessive- compulsive disorder alone had more obsessions concerning dirt or
germs and more cleaning compulsions. The subjects who had both disorders
reported that their compulsions arose spontaneously, whereas the subjects
with obsessive-compulsive disorder alone reported that their compulsions
were frequently preceded by cognitions. CONCLUSIONS: There are
phenomenologic differences between obsessive-compulsive disorder and
obsessive-compulsive disorder with comorbid Tourette's syndrome that may
reflect differential involvement of neurochemical and neuroanatomic
pathways.
