Frequency of body focused repetitive behaviors and comparison to self-injurious behaviors in patients with tic disorders

The majority of patients with chronic tic disorders suffer from psychiatric comorbidities, most frequently attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), depression, and anxiety. While characteristics of these psychiatric disorders are widely known, other comorbidities including self-injurious behaviors (SIB) and body focused repetitive behaviors (BFRB) are still under-investigated. Currently, there is a controversial discussion whether BFRB and SIB belong to the same spectrum because of clinical similarities or they represent distinct entities. In this study, we investigated the clinical profile of BFRB in a large sample of adult patients (N = 123) with chronic tic disorders. Current urge and/or behavior to perform BFRB was reported by 59 participants (48%). BFRB were overall more frequent in females, individuals with comorbid OCD, and more severe tics. Both urges and behaviors to perform BFRB had a negative impact on quality of life. When comparing patients with comorbid SIB and those with comorbid BFRB, SIB was found in younger patients with more severe tics and comorbid ADHD. From our data it is suggested that SIB and BFRB belong to the same spectrum with SIB indicating the more severe clinical manifestation.