Do children with OCD and tics have different characteristics and experiences compared to children with OCD alone?
Community Summary of: Tic-Related Obsessive-Compulsive Disorder (OCD): Phenomenology and Treatment Outcome in the Pediatric OCD Treatment Study II
Authors of the article in the Journal of the American Academy of Child and Adolescent Psychiatry: Christine A Conelea, Michael R Walther, Jennifer B Freeman, Abbe M Garcia, Jeffrey Sapyta, Muniya Khanna, Martin Franklin
Published online: December 2014
Community summary posted on September, 12, 2025
Word count: 546
Reading grade level: 8
Why does this study matter?
People can experience different symptoms when they have obsessive compulsive disorder (OCD). The guide professionals use to diagnose mental health challenges, the DSM, describes a type of OCD that includes tics. This type probably happens in 10-40% of people with OCD.
People with tic-related OCD are more likely to be male and experience symptoms earlier in childhood. Other differences aren’t clear in the research, especially for youth. Even though tic-related OCD has been defined, data from youth studies vary.
The reasons for the different data aren’t clear. They might relate to how the studies were designed or the participants who joined. However, all of these studies define tics using a strict DSM definition. Many more children with OCD have a lifetime history of tics (nearly 60%) than meet this strict definition.
This study used a broad definition to see whether children with OCD were different depending on whether or not they had tics. It looked at differences in age, gender, OCD symptoms, and other conditions. It also hypothesized that OCD-focused treatment would work less for people with tic-related OCD compared to those without tic-related OCD.
What happened?
Researchers used data from the Pediatric OCD Treatment Study II (POTS II). POTS II was a randomized controlled trial. It looked at whether cognitive behavioral therapy (CBT) helped youth who partially responded to a serotonin reuptake inhibitor (SRI) medication.
There were 124 youth aged 7-17 years in POTS II. Participants were randomly divided into 3 groups: medication, medication plus instructions in CBT, and medication plus full CBT groups.
Participants either had tic-related OCD (Tic +OCD) or OCD without tics. This was based on researchers identifying tics. Tics were identified in 53% of the group.
Those with tic-related OCD did not differ from those with non-tic-related OCD in terms of age, family history of tics, OCD severity, OCD impairment, or other conditions. Those with tics responded equally in all 3 groups.
What did this group learn?
Tic-related OCD was more common using a broad definition of tic status. Youth with this broad definition do not have more severe OCD symptoms, more problems, or worse functioning. CBT seems to work well with this group.
Tic status was classified based on current or lifetime motor and/or vocal tics. Using this definition, tic-related OCD was very common, occurring in 53% of the people. This is higher than the rate of tic disorders using the strict DSM definition.
This is consistent with prior research showing that many youth with OCD have a lifetime history of tics, and that the strict DSM definition may underestimate tics.
It’s important not to make broad assumptions about OCD symptoms that people with tics and OCD are most likely to experience.
What can researchers do next?
Future studies could add measures of these situations to see patterns for individual participants. They should examine these situations across longer periods so that researchers could do follow-up analysis.
Researchers could compare the usefulness of different definitions of tic-related OCD. It’s possible that differences in tic history impact how OCD looks and how well treatment works. Although the current results support the use of CBT for tic-related OCD, we still need to understand more about tics and OCD to improve treatment.
How can you find out more?
Please see full article