What Do We Currently Know About Functional Tic-Like Behaviors: A Topical Review

During the last 5 years, functional tic-like behaviors (FTLBs) have been the center of an increasing amount of scientific research.

The purpose of this review was to collect this research and create an overview of what is currently known about the patient group.

PubMed, EMBASE, and Web of Science were systematically searched for relevant papers, which were then sorted based on set inclusion and exclusion criteria. This process resulted in twenty-four papers selected for extraction, the results of which were summarized.

The results were split into three topics: characteristics, follow-ups, and treatment. Across studies on characteristics, patients with FTLB have overall higher symptom severity and complexity and a higher prevalence of anxiety and depression compared to the patients with Tourette syndrome included in the studies. The patients with Tourette syndrome had a higher prevalence of simple tics and comorbid attention-deficit/hyperactivity disorder and obsessive-compulsive disorder. However, in both populations there was considerable heterogeneity in both comorbidity profile as well as the characteristics of vocalizations and movements. The follow-up literature was relatively small but showed a general reduction in FTLB patients' symptoms over time, although spontaneous remission was rare. The treatment literature, which consisted of just two articles, showed good benefit of cognitive therapies.

Overall, the FTLB patient group presents with a wide variety of symptoms, which tends to persist but responds well to cognitive treatment. More research is needed particularly within the treatment literature.