Leckman J F, Walker D E, Goodman W K, Pauls D L, Cohen D J
Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900.
Am J Psychiatry. 1994 May;151(5):675-80. doi: 10.1176/ajp.151.5.675.
Tourette's syndrome is a chronic disorder of childhood onset that is characterized by motor and phonic tics and a broad range of associated behavior including obsessive-compulsive symptoms. Less well appreciated are the sensory and other perceptually tinged mental phenomena associated with both tic and compulsive behavior. This cross-sectional study evaluated the "just-right" phenomena commonly associated with compulsive behavior in subjects with tic disorders.
A total of 134 subjects with tic disorders, aged 9 to 71 years, completed a questionnaire concerning their current and past tic symptoms. Subjects were also asked to describe their "just right" perceptions. The Yale-Brown Obsessive Compulsive Scale was used to assess severity of current obsessive-compulsive symptoms.
Eight-one percent of the subjects with both Tourette's syndrome and obsessive-compulsive disorder (N = 31) and 56% of the subjects with Tourette's syndrome and obsessive-compulsive symptoms (N = 61) reported being aware of a need to perform compulsions until they were "just right." This awareness most commonly referred to visual or tactile (as opposed to auditory) features of the compulsive act or its consequences. Three-quarters of the subjects with these perceptions reported that they usually were aware of them immediately before or concurrently with the initiation of compulsions.
While epidemiological studies of tic disorders and obsessive-compulsive disorder have yet to incorporate questions concerning "just right" perceptions, these results suggest that such perceptions may be commonplace in adolescent and adult subjects with both obsessive-compulsive disorder and tic disorders. They also implicate brain regions involved in the processing of sensorimotor information in the pathobiology of tic disorders.
抽动秽语综合征是一种起病于儿童期的慢性疾病，其特征为运动性和发声性抽动以及包括强迫症状在内的一系列相关行为。与抽动和强迫行为相关的感觉及其他带有感知色彩的心理现象则较少受到关注。这项横断面研究评估了抽动障碍患者中通常与强迫行为相关的“恰到好处”现象。
总共134名年龄在9至71岁的抽动障碍患者完成了一份关于他们当前和过去抽动症状的问卷。受试者还被要求描述他们的“恰到好处”的感受。使用耶鲁-布朗强迫量表来评估当前强迫症状的严重程度。
患有抽动秽语综合征和强迫症的受试者中81%（N = 31）以及患有抽动秽语综合征和强迫症状的受试者中56%（N = 61）报告称意识到需要进行强迫行为，直到感觉“恰到好处”。这种意识最常涉及强迫行为或其后果的视觉或触觉（而非听觉）特征。有这些感受的受试者中四分之三报告称，他们通常在开始强迫行为之前或同时就意识到了这些感受。
虽然抽动障碍和强迫症的流行病学研究尚未纳入关于“恰到好处”感受的问题，但这些结果表明，这种感受在患有强迫症和抽动障碍的青少年及成年受试者中可能很常见。它们还表明在抽动障碍的病理生物学中，涉及感觉运动信息处理的脑区也有牵连。
