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Clinical features of tic-related obsessive-compulsive disorder: results from a large multicenter study


To evaluate the clinical features of obsessive-compulsive disorder (OCD) patients with comorbid tic disorders (TD) in a large, multicenter, clinical sample.


A cross-sectional study was conducted that included 813 consecutive OCD outpatients from the Brazilian OCD Research Consortium and used several instruments of assessment, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Yale Global Tic Severity Scale (YGTSS), the USP Sensory Phenomena Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders.


The sample mean current age was 34.9 years old (SE 0.54), and the mean age at obsessive-compulsive symptoms (OCS) onset was 12.8 years old (SE 0.27). Sensory phenomena were reported by 585 individuals (72% of the sample). The general lifetime prevalence of TD was 29.0% (n = 236), with 8.9% (n = 72) presenting Tourette syndrome, 17.3% (n = 141) chronic motor tic disorder, and 2.8% (n = 23) chronic vocal tic disorder. The mean tic severity score, according to the YGTSS, was 27.2 (SE 1.4) in the OCD + TD group. Compared to OCD patients without comorbid TD, those with TD (OCD + TD group, n = 236) were more likely to be males (49.2% vs. 38.5%, p < .005) and to present sensory phenomena and comorbidity with anxiety disorders in general: separation anxiety disorder, social phobia, specific phobia, generalized anxiety disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder, impulse control disorders in general, and skin picking. Also, the “aggressive,” “sexual/religious,” and “hoarding” symptom dimensions were more severe in the OCD + TD group.


Tic-related OCD may constitute a particular subgroup of the disorder with specific phenotypical characteristics, but its neurobiological underpinnings remain to be fully disentangled.

Corresponding author
*Address for correspondence: Maria Alice de Mathis, Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785 – 05403-010 São Paulo, SP, Brazil. (Email
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Both Pedro de Alvarenga and Maria Alice de Mathis and have contributed equally to this manuscript.

This study was supported by grants from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, Foundation for the Support of Research in the State of Sao Paulo): grant no. 08/57598-7 to Dr. De Mathis, grant no. 2005-55628-8 to Dr. Miguel, and grant no. 06/61459-7. Additional support was provided by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ, Brazilian Council for Scientific and Technological Development): grant no. 521369/96-7 to Dr. Miguel.

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CNS Spectrums
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