CDC - Tourette Syndrome, Diagnosing Tic Disorders - NCBDDD

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)1 is used by health professionals to help diagnose tic disorders.

Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a person with a motor tic might keep blinking over and over again. Or, a person with a vocal tic might make a grunting sound unwillingly.

Four tic disorders are included in the DSM-IV-TR:

• Tourette’s disorder (also called Tourette Syndrome [TS])
• Chronic motor or vocal tic disorder
• Transient tic disorder
• Tic disorder not otherwise specified

The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or a combination of both), and how long the symptoms have lasted. People with TS have both motor and vocal tics, and have had tic symptoms for at least 1 year. People with chronic motor or vocal tic disorders have either motor or vocal tics, and have had tic symptoms for at least 1 year. People with transient tic disorders can have motor or vocal tics, or both, but have had their symptoms less than 1 year. Tic disorder not otherwise specified is diagnosed when people have tics that do not meet criteria for one of the other disorders.

The criteria are presented here in modified form to make them more accessible to the general public. They are listed here for information purposes only and should not be used for self-diagnosis. If you are concerned about any of the symptoms listed, you should consult a trained health care provider with experience in diagnosing and treating tic disorders.

Tourette Syndrome (TS)

For a person to be diagnosed with TS, he or she must meet the following criteria:

1. The person must have both motor tics (for example, blinking or shrugging the shoulders) and vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time.
2. The person must have had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on, but there must not be a single tic-free period of more than 3 months.
3. The person’s tics must begin before he or she is 18 years of age.
4. The person’s symptoms must not be due to taking medicine or other drugs or to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis).

Chronic Motor or Vocal Tic Disorder

For a person to be diagnosed with a chronic tic disorder, he or she must meet the following criteria:

1. The person must have one or more motor tics (for example, blinking or shrugging the shoulders) or vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase), but not both
2. The person must have tics that occur many times a day nearly every day or on and off throughout a period of more than a year. During this period, there must not be a single tic-free period of more than 3 months.
3. The person’s tics must start before he or she is 18 years of age.
4. The person’s symptoms must not be due to taking medicine or other drugs or to having a another medical condition (for example, seizures, Huntington disease, or postviral encephalitis).
5. The person must not have been diagnosed with TS.

Transient Tic Disorder

For a person to be diagnosed with this disorder, he or she must meet the following criteria:

1. The person must have one or more motor tics (for example, blinking or shrugging the shoulders) or vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase).
2. The person must have tics that occur many times a day, nearly every day or at least 4 weeks, but for no longer than 12 months in a row.
3. The person’s tics must start before he or she is 18 years of age.
4. The person’s symptoms must not be due to taking medicine or other drugs or to having another medical condition (for example, Huntington disease or postviral encephalitis).
5. The person must not have been diagnosed with TS or chronic motor or vocal tic disorder.

Reference

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. 4th ed. Washington, DC; 2000.