Department of Psychiatry
Penn Behavioral Health

Center for the Treatment and Study of Anxiety

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Chronic Tic Disorder


Chronic Tic Disorders are characterized by the presence of either involuntary motor or vocal tics. The tic(s) occur several times a day, nearly every day or intermittently for a period of more than a year and never less than 3 months with an onset before the age of 18. When multiple motor tics and at least one verbal tic are simultaneously present, the diagnosis is known as Tourette’s syndrome.


Motor tics are involuntary and sudden body movements. Simple rapid movements, resembling a body spasm, are termed simple motor tics such as eye blinking, head jerks, and facial grimace. Complex motor tics are a series of intricate, seemingly organized sequence of movements (i.e. jumping, skipping, smelling objects, a string of movements). Verbal or phonic tics are involuntary, sudden vocalizations and classified in a similar manner. Simple verbal tics are short sporadic sounds (i.e. clicks, sniffs, coughs) whereas complex verbal tic are longer elaborate vocalization (i.e. barking, changes in pitch or tone, cursing).


Pharmacological treatments are often used to manage tic symptoms, and can include the use of typical and atypical neuroleptics (e.g., haldol, risperidone). Further, family therapy and psychotherapy are also commonly employed to help cope with the social and adjustment issues associated with these disorders. The best studied psychological treatment for Chronic Tic Disorders is a form of cognitive-behavioral therapy known as Habit Reversal Therapy (HRT), which has been found to be superior to comparison treatments in multiple studies conducted around the country. Treatment of tic disorders and their associated problems often involves a multi-component approach (e.g., pharmacotherapy plus CBT).


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