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Pediatric obsessive–compulsive disorder with tic symptoms: clinical presentation and treatment outcome

Abstract

Some studies have shown that children and adolescents with obsessive–compulsive disorder (OCD) and co-morbid tics differ from those without co-morbid tics in terms of several demographic and clinical characteristics. However, not all studies have confirmed these differences. This study examined children and adolescents with OCD and with possible or definite tic specifiers according to the DSM-5 in order to see whether they differ from patients without any tic symptoms regarding clinical presentation and outcome of cognitive behavioral therapy (CBT). The full sample included 269 patients (aged 7–17) with primary DSM-IV OCD who had participated in the Nordic Long-term Treatment Study (NordLOTS). Symptoms of tics were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). One or more tic symptoms were found in 29.9% of participants. Those with OCD and co-morbid tic symptoms were more likely male, more likely to have onset of OCD at an earlier age, and differed in terms of OCD symptom presentation. More specifically, such participants also showed more symptoms of OCD-related impairment, externalization, autism spectrum disorder (ASD), social anxiety, and attention-deficit/hyperactivity disorder (ADHD). However, the two groups showed no difference in terms of OCD severity or outcome of CBT. Children and adolescents with OCD and co-morbid tic symptoms differ from those without tic symptoms in several aspects of clinical presentation, but not in their response to CBT. Our results underscore the effectiveness of CBT for tic-related OCD.

Clinical trials registration: Nordic Long-term Obsessive–Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.

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Acknowledgements

The authors would like to thank TrygFonden, Lundbeck Foundation and Central Region Denmark’s Research Fund for supporting the research presented in this article through project Grants.

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Correspondence to Davíð R. M. A. Højgaard.

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Tord Ivarsson: Speaker’s bureau for Shire Sweden. On behalf of all other authors, the corresponding author states that there is no conflict of interest.

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Højgaard, D.R.M.A., Skarphedinsson, G., Nissen, J.B. et al. Pediatric obsessive–compulsive disorder with tic symptoms: clinical presentation and treatment outcome. Eur Child Adolesc Psychiatry 26, 681–689 (2017). https://doi.org/10.1007/s00787-016-0936-0

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Keywords

  • OCD
  • CBT
  • Pediatric
  • Tics
  • Treatment