Tic Disorders are listed under Motor Disorders in the DSM-5. A diagnosis of Tourette’s Disorder, a tic disorder, requires multiple motor tics and at least one vocal tic to be present and have begun before the age of 18. Both motor and vocal tic are required for this diagnosis. The tics must have persisted for more than a year but may be inconsistent in frequency. The disturbance should not be attributable to a substance or another medical condition.
Also listed in the DSM-5 under Tic Disorders are Persistent Motor or Vocal Tic Disorder and Provisional Tic Disorder. For a diagnosis of Persistent Motor or Vocal Tic Disorder one or multiple motor or vocal tics must be present, but not both. The disturbances must have started before age 18 and should have persisted for more than a year. The disturbance should not be attributable to a substance or another medical condition. Provisional Tic Disorder is given when the person meets the requirements for Tourette’s Disorder but the disturbances have been present for less than one year.
The typical onset of a tic is in early school age years; peeking around the preteen years. Symptoms may diminish into adulthood. Some people report a sensation or urge that precedes the tic and a feeling of reduced tension after the expression of the tic. This is different from OCD in that the tic is involuntary.
A tic is a sudden, rapid, recurrent, nonrhythmic, motor movement or vocalization, which can be either simple or complex. Simple motor tics are of very short duration, often milliseconds, and may include eye blinking, shoulder shrugging or extension of limbs. Simple vocal tics often include grunting, sniffing, or throat clearing. Complex motor ticks last longer and include a combination of tics. They can appear purposeful and can include a sexual or obscene gesture (copropraxia) or a tic-like imitation of someone else’s movements (echopraxia).Complex vocal tics can seem purposeful as well and include repeating one’s own sounds (palilalia), repeating word or phrase last heard (echolalia), or uttering socially unacceptable obscenities or racial, ethnic, or religious slurs (coprolalia).
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