Zusammenhänge zwischen Zwangsstörungen und Ticstörungen in einer kinder- und jugendpsychiatrischen Inanspruchnahmepopulation

Tic disorders and obsessive compulsive disorders show a high comorbidity. Up to now in the scientific literature there are no systematic comparisons of the subgroups - patients with tic-disorders only, - patients with OCD only and - patients with OCD and tic-disorders. The primary objective of this dissertation is a explorative data description of a clinical sample composed of three groups (44 patients with clear obsessive compulsive disorder / 8 patients with clear tic disorder / 16 patients with mixed disease). Four hypotheses are tested (gender ratio; social state; comorbid disorder; therapeutic success). The concordance between clinical diagnosis and diagnostic classification by research criteria proved to be moderate for obsessive compulsive disorder and good for tic disorder. 66,7% of tic patients show a comorbid obsessive compulsive disorder and 26,7% of patients with obsession und compulsion present comorbid tics. The hypothesis, that boys have more tics und girls have more compulsive disorders was confirmded. Significant differences between the three groups in respects of social state; comorbid disorder and therapeutic success were not found. Explorative comparisons showed significant differences between the three groups on the following variables: treatment, family background, language development, present attend school, school based disorder, acute stressed personal experiences and chronical interpersonal strain with school or work. It is concluded, that in clinical practice it is necessary to consider that in patients with tic disorders additionally an obsessive compulsive disorder may be present. Although patients with obsessive compulsive disorders and tic disorders show many similarities, disease-specific differences can be descirbed. The most marked discrepancies exist between patients with obsessive compulsive disorder and tic disorder only. The results of the dissertation support a dimensional model with a continuum of symptoms ranging from single tics to a mixed disorder up to clear obsessions and compulsions.