OBJECTIVES: to explore relevant aspects of the burden of OCTD.

METHODS: we conducted a Literature review and a pilot study using retrospective demographic, clinical and economic data of patients with OCTD accessing the Galeazzi Hospital in Milan.

RESULTS: the literature review provided an overview of the absence of information on OCTD. From 30 patients (80.0% male, 36.7% aged 7-13 years, 63.3% aged 15-48 years), 83.0% declared that obsessions and/or compulsions were the most important factors determining their social impairment. Adult patients refractory to only drug treatment underwent Deep Brain Stimulation plus drugs. The mean clinical scores of patients indicated a severe condition for both tics and OCB/OCD. The mean time elapsed from symptoms onset to diagnosis of OCTD was 5.6 years, reaching up to 11 years in one case. Before reaching the correct diagnosis, the patients were visited several times by different specialists, 93.3% underwent diagnostic examinations and 86.7% took 2/3 different drugs: neuroleptics (40.0%), antidepressants (36.7%), tetrabenazine/tiapride/topiramate (26.7%), anxiolytics (6.7%), 30.0% took antibiotics, homeopathic compounds, vitamins and/or cortisone. Ten patients were hospitalized and 8 underwent psychotherapy.

CONCLUSIONS: OCTD has been described recently as an early-onset and highly disabling endophenotype of Tic Disorder and Obsessive Compulsive Disorder. OCTD has a relevant but little known clinical, social and economic burden for patients and their families. Albeit preliminary, these results show that attention is mandatory for establishing correct diagnosis and treatment guidelines to improve health and rationally spend resources for OCTD.