Socio-demographic and clinical characterization of patients with Obsessive-Compulsive Tic-related Disorder (OCTD): an Italian multicenter study
B. Dell’Osso 1-3, B. Benatti 1, E. Hollander 4, J. Zohar 5, L. Dell’Osso 6, N.A. Fineberg 7, M. Marcatili 1, S. Rigardetto 8, M. Briguglio 9, D. Marazziti 6, F. Mucci 6, O. Gambini 3 10, A. Tundo 11, R. Necci 11, D. De Berardis 12 13, R. Galentino 9, S. De Michele 9, C. D’Addario 14 15, D. Servello 9, U. Albert 16, G. Maina 8, D. De Ronch 16, A.C. Altamura 1, M. Porta 9
1 Department of Psysiopathology and Transplantation, University of Milan, Italy; 2 Department of Psychiatry and Behavioral Sciences, Stanford University, CA, USA; 3 “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Italy; 4 Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA; 5 Department of Psychiatry, Chaim Sheba Medical Center, 52621 Tel Hashomer, Israel; 6 Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy; 7 University of Hertfordshire, Hatfield, UK and Hertfordshire Partnership Foundation Trust, Welwyn Garden City, UK; 8 San Luigi Gonzaga Hospital, Orbassano, University of Turin, Italy; 9 Department of Functional Neurosurgery, IRCCS Galeazzi Hospital, Tourette Center, Milan, Italy; 10 Department of Health Sciences, University of Milan, Italy; 11 Institute of Psychopathology, Rome, Italy; 12 NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4 Teramo, Italy; 13 Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University “G. D’Annunzio”, Chieti, Italy; 14 Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Italy; 15 Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; 16 Department of Biomedical and Neuromotor Sciences, Section of Psychiatry, Alma Mater Studiorum University of Bologna, Italy
In the DSM-5 a new “tic-related” specifier for obsessive compulsive disorder (OCD) has been introduced, highlighting the importance of an accurate characterization of patients suffering from obsessive-compulsive tic-related disorder (“OCTD”). In order to characterize OCTD from a socio-demographic and clinical perspective, the present multicenter study was carried out. The sample consists of 266 patients, divided in two groups with lifetime diagnoses of OCD and OCTD, respectively. OCTD vs OCD patients showed a significant male prevalence (68.5% vs 48.5%; p < .001), a higher rate of psychiatric comorbidities (69.4 vs 50%; p < .001) – mainly with neurodevelopmental disorders (24 vs 0%; p < .001), a lower education level and professional status (middle school diploma: 25 vs 7.6%; full-time job 44.4 vs 58%; p < .001). Moreover, OCTD vs OCD patients showed significantly earlier age of OCD and psychiatric comorbidity onsets (16.1 ± 10.8 vs 22.1 ± 9.5 years; p < .001, and 18.3 ± 12.8 vs 25.6 ± 9.4: p < .001, respectively). Patients with OCTD patients were treated mainly with antipsychotic and with a low rate of benzodiazepine (74.2 vs 38.2% and 20.2 vs 31.3%, respectively; p < .001). Finally, OCTD vs OCD patients showed higher rates of partial treatment response (58.1 vs 38%; p < .001), lower rates of current remission (35.5 vs 54.8%; p < .001) and higher rates of suicidal ideation (63.2 vs 41.7%; p < .001) and attempts (28.9 vs 8.3%; p < .001).
Patients with OCTD report several unfavorable socio-demographic and clinical characteristics compared to OCD patients without a history of tic. Additional studies on larger sample are needed to further characterize OCTD patients from clinical and therapeutic perspectives.