Tricky “Ticcy” Case: Tics/Tourette Syndrome with Co-occurring OCD

Abstract

Tourette syndrome and related tic disorders are complex, neuropsychiatric conditions that likely arise from fronto-subcortical circuit dysfunction. Individuals with these disorders often have additional neuropsychiatric comorbidities such as obsessive compulsive disorder and attention deficit hyperactivity disorder. Given their presumed overlapping genetic and neurodevelopmental origins, it is common for individuals to struggle with symptoms that overlap these diagnostic categories. As a result, careful attention must be paid to complete a thorough evaluation inclusive of these and other neuropsychiatric comorbidities, the presence of which helps to guide appropriate treatment, which includes specific psychotherapeutic and pharmacotherapeutic interventions for each of these disorders. This case of a young man exemplifies the complex and evolving experience of individuals struggling with Tourette syndrome and related disorders. His and his family’s stories provide a lesson in the natural history and diagnostic process of these neuropsychiatric conditions and serve as a starting point for discussion of neuropathological correlates and an in-depth discussion of pharmaco- and psychotherapeutic management.