Diniz Juliana B, Rosario-Campos Maria Conceição, Hounie Ana Gabriela, Curi Mariana, Shavitt Roseli Gedanke, Lopes Antonio Carlos, Miguel Euripedes C
Department of Psychiatry, University of São Paulo Medical School, R Dr Ovideo Pires de Campos, 785, 4degrees. andar/sala 3, São Paulo, SP 05403-010, Brazil.
J Psychiatr Res. 2006 Sep;40(6):487-93. doi: 10.1016/j.jpsychires.2005.09.002. Epub 2005 Nov 14.
Tourette syndrome (TS) and chronic motor/vocal tics (CMVT) are both common disorders in patients with obsessive compulsive disorder (OCD). However, there have been few studies evaluating the differences between the OCD with TS and OCD with CMVT subgroups. This study was conducted in order to further investigate possible differences between the expression of the OCD phenotype in OCD with TS and that seen in OCD with CMVT. One hundred and fifty-nine outpatients referred to an OCD research program were evaluated using the following instruments: the Structured Clinical Interview for DSM-IV; the Yale-Brown Obsessive Compulsive Scale; the Yale Global Tic Severity Scale; and the USP-HARVARD Repetitive Behaviors Interview. Patients were divided into three groups: OCD patients without tics (OCD-TICS, n=98), OCD patients with chronic motor or vocal tics (OCD+CMVT, n=31) and OCD patients with TS (OCD+TS, n=30). OCD+CMVT patients were similar to OCD+TS patients regarding the frequency of intrusive sounds, repeating behaviors, counting and tic-like compulsions (in both cases more frequent than in OCD-TICS patients). For age at obsessive-compulsive (OC) symptom onset, sensory phenomena score, number of comorbidities, frequency of somatic obsessions, bodily sensations and just-right perceptions, OCD+CMVT patients tended to be in between the other two groups. Our results suggest that there are qualitative and quantitative differences in the phenotypic expression of tic disorders in OCD patients, depending on whether the subject has TS or only CMVT.
抽动秽语综合征（TS）和慢性运动性/发声性抽动障碍（CMVT）在强迫症（OCD）患者中均为常见病症。然而，很少有研究评估患有TS的OCD患者与患有CMVT的OCD患者亚组之间的差异。进行这项研究是为了进一步探究患有TS的OCD患者与患有CMVT的OCD患者在OCD表型表达上可能存在的差异。使用以下工具对转介至一个OCD研究项目的159名门诊患者进行了评估：《精神疾病诊断与统计手册》第四版的结构化临床访谈；耶鲁-布朗强迫症量表；耶鲁全球抽动严重程度量表；以及美国药典-哈佛重复行为访谈。患者被分为三组：无抽动的OCD患者（OCD-TICS，n = 98）、患有慢性运动性或发声性抽动的OCD患者（OCD+CMVT，n = 31）以及患有TS的OCD患者（OCD+TS，n = 30）。在侵入性声音、重复行为、计数和抽动样强迫行为的频率方面（两种情况均比OCD-TICS患者更频繁），OCD+CMVT患者与OCD+TS患者相似。在强迫症状发作的年龄、感觉现象评分、共病数量、躯体强迫观念的频率、身体感觉和恰到好处的感知方面，OCD+CMVT患者往往介于其他两组之间。我们的结果表明，OCD患者抽动障碍的表型表达在质和量上存在差异，这取决于患者是患有TS还是仅患有CMVT。
