What actually is Tourettic OCD?
I've seen people using the tourettic OCD tag on posts that do not involve actual Tourettic OCD, so I thought I should make a post clearing up what it actually is.
Tourettic OCD (TOCD) is not recognized as it's own diagnosis in the DSM-5. It is considered a subtype of OCD, characterized by compulsions without the intrusive thoughts or anxiety. These anxietyless compulsions have been deemed "impulsions," to help differentiate them from regular OCD.
Impulsions are typically complex tic-like behaviors. Examples include: rubbing, tapping, counting, arranging, ordering, positioning, touching things in a specific way (ex: with a goal of symmetry or exactness), vocalizing phrases rather than simple sounds, or a multi-step sequence of movements (ex: several different hand movements in a row).
There is a lower tendency of impulsions related to checking, cleaning, and reassurance seeking.
OCD and chronic tic disorders are often comorbid conditions. Tics in TS, compulsions in OCD, and their preceding premonitory urges often overlap. Because of this, symptoms of TOCD must not equate to just having OCD and a comorbid tic disorder.
Onset of symptoms in TOCD typically happens at an early age, making it a predominantly pediatric diagnosis, with a higher rate in males.
Both TS and OCD involve a feeling of discomfort that precedes the behavior (tic or compulsion). In TS, the discomfort is physical or sensory (the premonitory urge), while in OCD, the discomfort is emotional and anxiety related (the obsession).
Patients with TOCD rarely experience obsessional thoughts. Their behaviors are instead driven by a sense of physical discomfort, similar to in tic disorders. This physical discomfort is often described as something feeling incomplete or "not right," and is what drives the person to act out the behaviors.
Despite the impulsions in TOCD not being driven by anxiety, the physical sensation can become anxiety provoking, if the behavior is not acted on.
Because they are not driven by anxiety, impulsions are not goal directed, like regular compulsions in OCD.
Patients with TOCD often repeat impulsions multiple times, until they feel "right," and the discomforting sensation goes away.
TOCD treatment is complex and symptoms are often treatment resistant. TOCD doesn't respond well to medications, so treatment mainly entails Exposure and Response Prevention (ERP) therapy.
Obsessive compulsive disorder (OCD) and chronic tic disorders (CTD) including Tourette Syndrome (TS) are often comorbid conditions. While so
When most people think of Obsessive-Compulsive Disorder (OCD), they envision repetitive behaviors like checking locks or excessive handwashi