Tic disorder
Examples of tics
SpecialtyNeurology, psychiatry

Tic disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, nonrhythmic movements).[1] Tic disorders are defined similarly by the World Health Organization (ICD-10 codes).[2]



The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in May 2013, classifies Tourette syndrome and tic disorders as motor disorders listed in the neurodevelopmental disorder category.[3]

Tic disorders, in ascending order of severity, are:[3]

Developmental coordination disorder and stereotypic movement disorder are also classified as motor disorders.[4][5]


ICD10 diagnosis codes are:[6]


Further information: Tic § Differential diagnosis

Tics should be distinguished from other causes of tourettism, stereotypies, chorea, dyskinesias, myoclonus and obsessive-compulsive disorder.[3]


Education, and a "watch and wait" strategy, are the only treatment needed for many, and most individuals with tics do not seek treatment. When needed, management of tic disorders is similar to management of Tourette syndrome.[7] The first line of treatment is behavioural therapy, followed by medication (most often aripiprazole) if the former is unsuccessful.[8]

Although behavioural therapy is the recommended first treatment, many people with tics do not access it due to the lack of trained psychotherapists.[8]


Tic disorders are more commonly diagnosed in males than females.[3]

At least one in five children experience some form of tic disorder, most frequently between the ages of seven and twelve.[9][10] Tourette syndrome is the more severe expression of a spectrum of tic disorders, which are thought to be due to the same genetic vulnerability. Nevertheless, most cases of Tourette syndrome are not severe. Although a significant amount of investigative work indicates genetic linkage of the various tic disorders, further study is needed to confirm the relationship.[11]



In the fourth revision of the DSM (DSM-IV-TR), tic disorders were classified as follows:[12]

From DSM-IV-TR to DSM-5

DSM-5 was published in 2013, updating DSM-IV-TR, which was published in 2000. The following changes were made:[3][13][14][4]


  1. ^ "DSM-IV-TR: Tourette's Disorder". Diagnostic and Statistical Manual of Mental Disorders (4th text revision (DSM-IV-TR) ed.). American Psychiatric Association. 2000. ISBN 0-89042-025-4.
  2. ^ Swain JE, Scahill L, Lombroso PJ, King RA, Leckman JF (August 2007). "Tourette syndrome and tic disorders: a decade of progress". Journal of the American Academy of Child and Adolescent Psychiatry. 46 (8): 947–968. doi:10.1097/chi.0b013e318068fbcc. PMID 17667475.
  3. ^ a b c d e f g American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 81–85. ISBN 978-0-89042-555-8.
  4. ^ a b "Highlights of changes from DSM-IV-TR to DSM-5" (PDF). American Psychiatric Association. 2013. Archived from the original (PDF) on February 3, 2013. Retrieved June 5, 2013.
  5. ^ Robertson MM, Eapen V (October 2014). "Tourette's: syndrome, disorder or spectrum? Classificatory challenges and an appraisal of the DSM criteria". Asian Journal of Psychiatry (Review). 11: 106–113. doi:10.1016/j.ajp.2014.05.010. PMID 25453712.
  6. ^ "ICD Version 2006". World Health Organization. Retrieved 24 May 2007.
  7. ^ Roessner V, Plessen KJ, Rothenberger A, Ludolph AG, Rizzo R, Skov L, Strand G, Stern JS, Termine C, Hoekstra PJ (April 2011). "European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment". European Child & Adolescent Psychiatry. 20 (4): 173–96. doi:10.1007/s00787-011-0163-7. PMC 3065650. PMID 21445724.
  8. ^ a b Müller-Vahl KR, Szejko N, Verdellen C, Roessner V, Hoekstra PJ, Hartmann A, Cath DC (March 2022). "European clinical guidelines for Tourette syndrome and other tic disorders: summary statement". European Child & Adolescent Psychiatry. 31 (3): 377–382. doi:10.1007/s00787-021-01832-4. PMC 8940881. PMID 34244849.
  9. ^ a b Black KJ, Black ER, Greene DJ, Schlaggar BL (2016). "Provisional Tic Disorder: What to tell parents when their child first starts ticcing". F1000Research. 5: 696. doi:10.12688/f1000research.8428.1. PMC 4850871. PMID 27158458.
  10. ^ "Tourette Syndrome Fact Sheet". National Institutes of Health (NIH). Archived from the original on 23 March 2005. Retrieved 23 March 2005.
  11. ^ Swerdlow NR (September 2005). "Tourette syndrome: current controversies and the battlefield landscape". Current Neurology and Neuroscience Reports. 5 (5): 329–31. doi:10.1007/s11910-005-0054-8. PMID 16131414. S2CID 26342334.
  12. ^ Evidente VG (October 2000). "Is it a tic or Tourette's? Clues for differentiating simple from more complex tic disorders". Postgraduate Medicine. 108 (5): 175–6, 179–82. doi:10.3810/pgm.2000.10.1257. PMID 11043089. S2CID 43162987.
  13. ^ Neurodevelopmental disorders. American Psychiatric Association. Retrieved on December 29, 2011.
  14. ^ Moran M (18 January 2013). "DSM-5 provides new take on neurodevelopment disorders". Psychiatric News. 48 (2): 6–23. doi:10.1176/appi.pn.2013.1b11.
  15. ^ Ellis CR, Pataki C. "Background: Childhood Habit Behaviors and Stereotypic Movement Disorder". Medscape. Retrieved October 6, 2013.
  16. ^ a b c d e Plessen KJ (February 2013). "Tic disorders and Tourette's syndrome". European Child & Adolescent Psychiatry. 22 (Suppl 1): S55–60. doi:10.1007/s00787-012-0362-x. PMID 23224240. S2CID 12611042.
  17. ^ Black, Kevin J. (17 February 2018). "ADHD medications and tics". Washington University School of Medicine.

Further reading