Treating Kids With OCD and Tourette's

Tourette’s syndrome is often diagnosed alongside obsessive-compulsive disorder. Barbara Coffey, MD, a clinical psychiatrist, talks about how treating OCD effectively can actually have a profound effect on the tic symptoms of Tourette’s. Dr. Coffey is Chief of the Division of Child and Adolescent Psychiatry and Professor of Psychiatry at the University of Miami Miller School of Medicine.

We know there is a overlap of OCD and tic symptoms. They tend to co-occur with one another. We know there’s a pretty well established genetic relationship in that if you see a child with tics or Tourette’s, you’re likely to see family members who also have OCD, even if they don’t have tics. That genetic relationship is not so well established for ADHD, but we see both as co-occurring in our clinical practice. In terms of intervention for OCD and tics, OCD is now no longer an anxiety disorder in the DSM, but there are many aspects of it that have to do with anxiety, and that can often augment or intensify the tic symptoms in a child who has both.

The treatments are different, but there’s no systematic or strong evidence base for the fact that treating OCD will make the tics worse as we do see on the ADHD side, but what I’ve found, since kids who have OCD are often quite anxious and worried, is if you can treat the anxiety and treat the OCD secondarily, the tics will reduce so that you don’t have to do anything directly for the tics. We have good behavioral interventions that could deal with both at the same time, both OCD and tics. So, it’s less of a complication, if you will, than it is with treating ADHD and tics or Tourette’s.