Send to

Choose Destination
J Clin Psychiatry. 2016 Oct;77(10):e1240-e1247. doi: 10.4088/JCP.14m09736.

Tic-Related Versus Tic-Free Obsessive-Compulsive Disorder: Clinical Picture and 2-Year Natural Course.

Author information

VU University Medical Center, VUmc 02 Building, Department of Anatomy and Neurosciences, De Boelelaan 1108, 1081 HZ, Amsterdam, the Netherlands.,
Department of Psychiatry, VU University Medical Center, and GGZ inGeest, Amsterdam, the Netherlands.
Department of Anatomy and Neuroscience, VU University Medical Center, Amsterdam, the Netherlands.
Altrecht Academic Anxiety Center, Utrecht, the Netherlands.
Department of Clinical and Health Psychology, Utrecht University, the Netherlands.
Dimence Mental Health Care, Almelo, the Netherlands.



The tic-related subtype of obsessive-compulsive disorder (OCD) has a distinct clinical profile. The course of tic-related OCD has previously been investigated in treatment studies, with inconclusive results. This study aimed to compare clinical profiles between tic-related and tic-free OCD patients and to establish the influence of tics on the 2-year natural course in adult OCD patients.


Within the Netherlands OCD Association cohort, 377 patients with a current DSM-IV diagnosis of OCD were divided into a tic-related group (28%) and a tic-free group and compared on clinical variables with t tests or χ² tests. Linear mixed-model analyses were used to compare the 2-year course between the groups, with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) as primary outcome measure. Data were collected from 2005 to 2007 and from 2007 to 2009.


Compared to patients with tic-free OCD, those with tic-related OCD reported earlier disease onset (P = .009) and more symmetry/ordering symptoms (P = .002). Overall symptom severity was similar in both groups. Patients with tic-related OCD reported increased traits of attention-deficit hyperactivity (P < .001) and autism (P = .005) compared to the tic-free OCD group. Clinical improvement at 2-year follow-up (mean = 5.3-point decrease on the Y-BOCS, P < .001, 95% CI = 4.3 to 6.3) was not significantly moderated by tic status (P = .24). This remained unchanged after correcting for baseline differences.


Tics do not critically affect the 2-year course of adult OCD, but tic-related OCD shows differences from tic-free OCD, such as early onset and increased autism and ADHD traits, that may indicate a neurodevelopmental subtype.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Physicians Postgraduate Press, Inc.
Loading ...
Support Center