The Complex Overlap of OCD and Tourette’s
Recently, I have been deep-diving into the research on Tourette’s, OCD, and the overlap between the two. These two distinct, yet interwoven, disorders share a fascinating neurological basis, behaviors, and thought patterns.
Research suggests that tic disorders are incredibly under-diagnosed, with up to 1 in 10 children having tics at some point in childhood development.
Whether you are a clinician, a parent, or other provider, we owe it to those we care for to be informed and knowledgeable about these disorders.
What is Tourette’s Syndrome?
Tourette's syndrome is a neurological condition characterized by repetitive, involuntary movements and vocalizations known as tics. These tics can be motor (such as blinking, jerking, or facial grimacing) or vocal (like grunting, throat clearing, or repeating words). Tourette’s begins in childhood, and while tics may lessen in adulthood, the impact on a person’s social and emotional life can be long-lasting.
What is Obsessive-Compulsive Disorder?
OCD is a mental health condition marked by intrusive, unwanted thoughts (obsessions) and repetitive behaviors (compulsions) that individuals feel driven to perform. These behaviors often serve to relieve anxiety or prevent something bad from happening. Common compulsions include checking, cleaning, counting, or repeating actions until they feel "just right."
So How do OCD and Tourette’s Overlap?
Many individuals with Tourette’s also exhibit symptoms of OCD, particularly in adolescence and in to adulthood. The overlap occurs in part because both conditions are thought to involve similar neurobiological circuits, particularly those related to the basal ganglia, an area of the brain involved in controlling motor functions and habits. Research suggests a genetic and neurobiological connection between the two disorders. Both OCD and Tourette’s involve dysfunction in brain circuits responsible for habit formation, decision-making, and the regulation of repetitive behaviors. Family studies show that having a relative with either OCD or Tourette’s increases the likelihood of developing the other condition.
Key Areas of Overlap:
Repetitive Behaviors: In both disorders, individuals may perform repetitive actions. However, in OCD, these behaviors are usually driven by an internal obsession (e.g., washing hands to prevent illness). In Tourette’s, tics are often more automatic and less connected to specific fears or thoughts.
Sensory Differences: Individuals with Tourette’s often report a sensory urge or discomfort before performing a tic, sometimes described as a premonitory urge. Similarly, people with OCD may experience discomfort or anxiety if they don’t complete their compulsions.
Overlap of Impulsivity and/or Compulsions: Tics are generally seen as more impulsive, automatic actions, while OCD compulsions are deliberate and performed to relieve distress. However, many individuals with Tourette’s report feeling compelled to carry out their tics, blurring the line between tics and compulsions.
Overlap in Treatment: Treatment recommendations for the two disorders actually share a lot of commonality. For example, Habit Reversal Training, often used as a first line treatment for Tourette’s, shares many therapeutic components of Exposure and Response Prevention, the first-line treatment in OCD.
Grounded Roots Family Development Center in Abilene is proud to specialize in evidence-based, structured approaches to the treatment of Tic Disorders and OCD. Through compassionate utilization of Comprehensive Behavioral Intervention for Tics (C-BIT), Exposure and Response Prevention (ERP), and Habit Reversal Training (HRT), we are honored to enrich the lives of children and families in our care.
Want to learn more? Check out information about CBIT here.
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