Tic Disorders
Tic Disorders encompass a spectrum of conditions characterised by sudden, repetitive, involuntary movements or vocalisations (tics). Tourette Syndrome, the most well-known and severe presentation, involves multiple motor tics and at least one vocal tic persisting for over a year. Tics are frequently preceded by a premonitory urge – an uncomfortable physical sensation that builds until the tic is performed, offering brief relief before the cycle repeats.
Dr. Patel’s clinical approach centres on Habit Reversal, the leading evidence-based behavioural treatment for tics. Habit Reversal works by building awareness of premonitory urges and training a competing response – a deliberate, incompatible action performed at the first sign of the urge, which interrupts the tic cycle over time without suppressing it through effortful, exhausting resistance.
Tic Disorders are frequently misunderstood in isolation. A substantial proportion of individuals with Tic Disorders also experience obsessive-compulsive symptoms, and the overlap between the two extends beyond simple co-occurrence – the intrusive urges driving tics and the intrusive thoughts driving Obsessive-Compulsive Disorder can share underlying mechanisms. Individuals whose tics are entangled with obsessional or compulsive features may be presenting with Tourettic Obsessive-Compulsive Disorder, a distinct condition explored on its own dedicated page.
Dr. Patel’s clinical work within the National Tourette Syndrome Service at the National Hospital for Neurology and Neurosurgery, alongside his ongoing doctoral research into tic-obsessive-compulsive comorbidity, means treatment is informed by both direct specialist experience and close engagement with the current evidence base – rather than a generalist approach applied to a highly specific presentation.
Dr. Dipesh Patel 