Tourettic Obsessive-Compulsive Disorder
Tourettic Obsessive-Compulsive Disorder (TOCD) is a term used to describe presentations in which tic and obsessive-compulsive phenomena overlap in ways that can be difficult to separate clinically. Individuals may experience premonitory urges, sensory incompleteness, “not just right” experiences, compulsions and repetitive behaviours that do not fit neatly within a conventional Tic Disorder or Obsessive-Compulsive Disorder formulation.
TOCD is not currently a separate diagnostic category, and the distinction between tics and compulsions is not always straightforward. Assessment therefore focuses on what precedes a behaviour, what the person is trying to achieve through it, and what happens when the behaviour is resisted. This can help identify whether a behaviour is primarily associated with a premonitory urge, an obsessional concern, a sense of incompleteness, or a combination of these experiences.
Dr. Patel’s doctoral research at the UCL Queen Square Institute of Neurology examines the overlap between Tic Disorders and Obsessive-Compulsive Disorder, with particular attention to the phenomenology of TOCD and its implications for psychological intervention.
His clinical approach can draw on Exposure and Response Prevention (ERP) and Habit Reversal Training (HRT), individually formulated according to the processes underlying each person’s symptoms. Where tic and obsessive-compulsive phenomena occur together, elements of these approaches may be integrated according to the individual presentation.
Individuals experiencing overlapping tic and obsessive-compulsive symptoms are welcome to get in touch to discuss whether an assessment or psychological intervention may be appropriate.
