title: Pediatric obsessive-compulsive disorder with tic symptoms: clinical presentation and treatment outcome.
abstract: Some studies have shown that children and adolescents with obsessive-compulsive disorder (OCD) and co-morbid tics differ from those without co-morbid tics in terms of several demographic and clinical characteristics. However, not all studies have confirmed these differences. This study examined children and adolescents with OCD and with possible or definite tic specifiers according to the DSM-5 in order to see whether they differ from patients without any tic symptoms regarding clinical presentation and outcome of cognitive behavioral therapy (CBT). The full sample included 269 patients (aged 7-17) with primary DSM-IV OCD who had participated in the Nordic Long-term Treatment Study (NordLOTS). Symptoms of tics were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). One or more tic symptoms were found in 29.9% of participants. Those with OCD and co-morbid tic symptoms were more likely male, more likely to have onset of OCD at an earlier age, and differed in terms of OCD symptom presentation. More specifically, such participants also showed more symptoms of OCD-related impairment, externalization, autism spectrum disorder (ASD), social anxiety, and attention-deficit/hyperactivity disorder (ADHD). However, the two groups showed no difference in terms of OCD severity or outcome of CBT. Children and adolescents with OCD and co-morbid tic symptoms differ from those without tic symptoms in several aspects of clinical presentation, but not in their response to CBT. Our results underscore the effectiveness of CBT for tic-related OCD.
  
  
  BACKGROUND
  Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com ; ISRCTN66385119.
authors.affiliation: Center for Child Adolescent Psychiatry, Aarhus University Hospital Risskov, Central Denmark Region, Skovagervej 2, Indgang 81, 8240, Risskov, Denmark. davmar@rm.dk.
authors.forename: Davíð R M A
authors.identifier: http://orcid.org/0000-0002-6676-2492
authors.initials: DRMA
authors.lastname: Højgaard
authors.affiliation: Department of Mental Health, Sorlandet Hospital, Kristiansand, Norway.
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Skarphedinsson
authors.affiliation: Center for Child Adolescent Psychiatry, Aarhus University Hospital Risskov, Central Denmark Region, Skovagervej 2, Indgang 81, 8240, Risskov, Denmark.
authors.forename: Judith Becker
authors.initials: JB
authors.lastname: Nissen
authors.affiliation: Center for Child Adolescent Psychiatry, Aarhus University Hospital Risskov, Central Denmark Region, Skovagervej 2, Indgang 81, 8240, Risskov, Denmark.
authors.forename: Katja A
authors.initials: KA
authors.lastname: Hybel
authors.affiliation: The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway.
authors.forename: Tord
authors.initials: T
authors.lastname: Ivarsson
authors.affiliation: Department of Mental Health, Sorlandet Hospital, Kristiansand, Norway.
authors.forename: Per Hove
authors.initials: PH
authors.lastname: Thomsen
mesh_terms: D000293:Adolescent; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D013981:Tic Disorders / Q000175:diagnosis*; D016896:Treatment Outcome
keywords: CBT; OCD; Pediatric; Tics; Treatment