Older article, but always worth re-reading I find.
http://www.acnp.org/g4/GN401000161/CH.html
Tic Disorders
James F. Leckman, Bradley S. Peterson, David L. Pauls
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For more than 60% of TS patients, persistent obsessive compulsive symptoms appear a few years after the onset of the tic symptoms (19,79,88). Some portion of these individuals go on to develop full blown OCD and may experience enduring OC symptoms even though their TS symptoms have otherwise diminished.
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Tic-related OCD typically includes symptoms of aggressive, sexual and religious obsessions and related compulsions as well as obsessions of symmetry and exactness and associated arranging and counting compulsions
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Although similar in many respects to other forms of OCD, tic-related OCD may be distinctive in terms of its earlier age of onset; the prominence of such symptoms as ritualized touching, tapping, and rubbing; and its relative refractoriness to serotonin reuptake inhibitors and responsiveness to augmentation with typical and atypical neuroleptics (57)
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Many TS patients suffer from other comorbid psychiatric disorders including major depression and various anxiety disorders (18,19). The presence of a bipolar diathesis may herald a particularly problematic course
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