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Phenomenological differences appearing with repetitive behaviours in obsessive-compulsive disorder and Gilles de la Tourette's syndrome

  • Euripedes C. Miguel (a1), Lee Baer (a2), Barbara J. Coffey (a3), Scott L. Rauch (a2), Cary R. Savage (a2), Richard L. O'Sullivan (a2), Katharine Phillips (a4), Cara Moretti (a2), James F. Leckman (a5) and Michael A. Jenike (a2)...
Abstract
Background

Obsessive–compulsive disorder (OCD) is heterogeneous, with some forms related to Gilles de la Tourette's syndrome (GTS). This is a phenomenological study designed to investigate the nature of these possible OCD subtypes and the relationship between OCD and GTS.

Method

We evaluated 20 adult outpatients with OCD, 21 with GTS, and 20 with OCD plus GTS using a semi-structured interview designed to assess cognitive, sensory and autonomic phenomena preceding repetitive behaviours.

Results

More cognitions and autonomic anxiety and fewer sensory phenomena were reported in OCD than in GTS. Like the GTS group, the OCD plus GTS group reported more sensory phenomena and fewer cognitions than the OCD group.

Conclusions

The presence or absence of cognitions, sensory phenomena, and autonomic anxiety distinguishes repetitive behaviours in patients with OCD from those with OCD plus GTS, and GTS. These subjective experiences may be useful in subtyping OCD and may represent valid predictors of prognosis and treatment response.

Copyright
Corresponding author
Euripedes C. Miguel, Instituto de Psiquiatria do Hospital das Clinicas da Falculdade de Medicina da USP, Rua Ovidio Pires de Campos s/no. São Paulo SR, CEP: 05430-010, Brasil, e-mail: ECMIGUEL@USP.BR; Fax: 011-280-0842
References
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Alexander, G. E., Crutcher, M. D. & DeLong, M. R. (1990) Basal ganglia-thaiamocortical circuits: Parallel substrates for motor, oculomotor, “prefrontal” and “limbic” functions. In Progress in Brain Research (eds Bylings, H. B. M., Van Eden, C. G., De Bruin, J. PC. et al), pp 119146. Amsterdam: Elsevier Scientific Publishers.
American Psychiatric Assosiation (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III-R). Washington, DC: APA.
Baer, L. (1994) Factor analysis of symptom subtypes of obsessive-compulsive disorder and their relation to personality and tic disorder. Journal of Clinical Psychiatry, 55(suppl). 1823.
Baxter, L. R., Schwartz, J. M., Guze, B. H., et al (1990) Neuroimaging in obsessive-compulsive disorder: seeking the mediating neuroanatomy In Obsessive Compulsive Disorder: Theory and Managenient (2nd edn) (eds Jenike, M. A., Baer, L. & Minichiello, W. E.). pp 167188. Chicago, IL: Mosby Year Book Medical Publishers.
Beck, A. T., Ward, C. H. Mendolson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry 4, 561571.
Beck, A. T., Ward, C. H. Mendolson, M., Epstein, N., Brown, G., et al (1988) An inventory for measuring clinical anxiety: psychonnetric properties. Journal of Consulting and Clinical Psychology, 56, 893897.
Carr, A. (1974) Compulsive neurosis: a review of the literature. Psychological Bulletin, 81 311 318.
Cohen, A. J. & Leckman, J. F. (1992) Sensory phenomena associated with Gilles de la Tourettes syndrome, Journal of Clinical Psychiatry, 53, 319323.
George, M. S., Trimble, M. R., Ring, H. A., et al (1993) Obsessions in obsessive compulsive disorder with and without Gilles de la Tourettes syndrome. American Journal of Psychiatry, 150, 9397.
Goodman, W. K., Price, L. H., Rasmussen, S. A. et al (1989a) The Yale-Brown obsessive compulsive scale: I. development use and reliability. Archives of General Psychiatry, 46, 10061011.
Goodman, W. K., Price, L. H., Rasmussen, S. A., et al (1989b) The Yale-Brown obsessive compulsive scale: II. validity Archives of General Psychiatry, 46, 10121016.
Hodgson, R. J. & Rachman, S. (1972) The effects of contamination and washing in obsessional patients. Behaviour Research and Therapy, 101, 111117.
Hohen-Saric, R., McLeod, D. R. & Hipsley, P. (1995) Is hyperarousal essential to obsessive-compulsive disorder? Archives of General Psychiatry, 52, 688693.
Holzer, J. C., Goodman, W. K., McDougle, C. J. et al (1994) Obsessive-compulsive disorder with and without a chronic tic disorder. A comparison of symptoms in 70 patients. British Journal of Psychiatry, 164, 469473.
Leckman, J. F., Riddle, M. A., Hardin, M. T., et al (1989) The Yale Global Tic Severity Scale: initial testing of a clinican-rated scale of tic severity Journal of the American Academy of Child and Adolescent Psychiatry 28, 566573.
Leckman, J. F., Riddle, M. A., Hardin, M. T., Wallcer, D. E., & Cohen, D. J. (1993) Premonitory urges in Tourettes syndrome. American Journal of Psychiatry 150, 98102.
Leckman, J. F., Riddle, M. A., Hardin, M. T., Wallcer, D. E., & Cohen, D. J., Wallcer, D. E., Goodman, W. K., et al (1994) “Just-right” perceptions associated with compulsive behaviour in Tourettes syndrome. American Journal of Psychiatry, 151, 675680.
Leckman, J. F., Riddle, M. A., Hardin, M. T., Wallcer, D. E., & Cohen, D. J., Wallcer, D. E., Goodman, W. K., Grice, D. E., Barr, L. C. et al (1995) Tic-related vs. non-tic-related obsessive-compulsive disorder Anxiety, 1, 208215.
Leonard, H. L., Lenane, M. C., Swedo, S. E., et al (1992) Tics and Tourettes disorder: a 2- to 7- year follow-up of 54 obsessive-compulsive children. American Journal of Psychiatry 149, 12441251.
McDougle, C. J., Goodman, W. K., Leckman, J. F., et al (1994) Haloperidol addition in fluvoxamine-refractory obsessive compulsive disorder A double-blind, placebo-controlled study in patients with and without tics. Archives of General Psychiatry, 51, 302308.
Miguel, E. C., Coffey, B. J., Baer, L., et al (1995) Phenomenology of intentional repetitive behaviours in obsessive-compulsive disorder and Tourettes syndrome. Journal of Clinical Psychiatry, 56, 246255.
Modell, J., Mountz, J., Curtis, G. et al (1989) Neurophysiologic dysfunction in basal ganglia/limbic striatal and thalamocortical circuits as a pathogenetic mechanism of obsessive-compulsive disorder Journal of Neuropsychiatry I, 2736.
Pauls, D. L. & Leckman, J. F. (1986) The inheritance of Gilles de la Tourettes syndrome and associated behaviours: evidence for autosomal dominant transmission. New England Journal of Medicine. 315, 993997.
Pauls, D. L. & Leckman, J. F., Alsobrock, J. P. II, Goodman, W., et al (1995) A family study of obsessive-compulsive disorder American Journal of Psychiatry, 152, 7684.
Pitman, R. K., Green, R. C., Jenike, M. A., et al (1987) Clinical companson of Tourettes disorder and obsessive-compulsive disorder American Journal of Psychiatry, 144, 11661171.
Robertson, M. M., Trimble, M. R. & Lees, A. J. (1988) The psychopathology of the Gilles de la Tourette syndrome. A phenomenological analysis. British Journal of Psychiatry, 152, 383390.
Spitzer, R. L., Williams, J. B. W., Gibbon, M., et al (1988) Structured Clinical Interview for DSM-III-R-patient version (SCID-OP, 6/11/1988). New York. NY Biometrics Research Department.
Tourette Syndrome Classification Study Group (1993) Definitions and classification of tic disorders. Archives of Neurology, 50, 10131016.
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Phenomenological differences appearing with repetitive behaviours in obsessive-compulsive disorder and Gilles de la Tourette's syndrome

  • Euripedes C. Miguel (a1), Lee Baer (a2), Barbara J. Coffey (a3), Scott L. Rauch (a2), Cary R. Savage (a2), Richard L. O'Sullivan (a2), Katharine Phillips (a4), Cara Moretti (a2), James F. Leckman (a5) and Michael A. Jenike (a2)...
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