[Compulsive disorder and Gilles de la Tourette syndrome. On the differential diagnosis of organic and psychogenic compulsive symptoms].

A high prevalence of obsessions and compulsions is recognized in patients with Gilles-de-la-Tourette syndrome. Comparison of a group of patients with Gilles-de-la-Tourette syndrome with a group with obsessive-compulsive disorder, using the diagnostic criteria of the DSM-III-R, showed significantly higher scores in both groups of patients in the Hamburg obsessive-compulsive inventory (short version) than in a control group. When selected items from this Inventory were entered in a discriminant analysis, it was shown that there were specific differences in the obsessive-compulsive symptoms in the Gilles-de-la-Tourette syndrome compared to an obsessive-compulsive disorder. Eighty-eight percent of the patients were correctly classified with respect to their diagnosis with eight items of the Hamburg obsessive-compulsive inventory. This result leads to the conclusion that differential observation of the psychopathology of obsessions and compulsions can contribute to the differential diagnosis in obsessive-compulsive disorder and Gilles-de-la-Tourette syndrome, which is still underdiagnosed in Germany compared to epidemiological data in the USA. Moreover, the different psychopathology may reflect differences between a neurotic and an organic basis for obsessions and compulsions.