Chronic phonic tic disorder

Essential (Required) Features:

• The persistent presence of phonic tic(s).
• Phonic tics are defined as sudden, rapid, non-rhythmic, and recurrent vocalizations.
• Phonic tics have been present for at least 1 year with onset during the developmental period.

Additional Clinical Features:

• Phonic tics may be voluntarily suppressed for short periods of time, may be exacerbated by stress, and may diminish during sleep or during periods of focused enjoyable activity.
• Tics are often highly suggestible, for example such that when an individual with Chronic Phonic Tic Disorder is asked about specific symptoms, old tics that have been absent for some time may transiently reappear.

Boundary with Normality (Threshold):

• Transient phonic tics (e.g., throat clearing) are common during childhood and are differentiated from Chronic Motor Tic Disorder and Chronic Phonic Tic Disorder by their transient nature.

Culture-Related Features:

• If vocalizations have a specific function or meaning in the context of an individual’s culture and are used in ways that are consistent with that cultural function or meaning, they should not be considered evidence of Chronic Phonic Tic Disorder.

Sex- and/or Gender-Related Features:

• Women with persistent tic disorders may be more likely to experience co-occurring Anxiety or Fear-Related Disorders and Depressive Disorders.

Boundaries with Other Disorders and Conditions (Differential Diagnosis) :

• Boundary with Obsessive-Compulsive Disorder: Repetitive, recurrent vocalizations can also be symptomatic of Obsessive-Compulsive Disorder. Tics can be differentiated from Obsessive-Compulsive Disorder because they appear unintentional in nature and clearly utilize a discreet muscle group. However, it can be difficult to distinguish between complex tics and compulsions associated with Obsessive-Compulsive Disorder. Although tics (both complex and simple) are preceded by premonitory sensory urges, which may diminish over time, tics are not aimed at neutralizing antecedent cognitions (e.g., obsessions) or reducing physiological arousal (e.g., anxiety). Many individuals exhibit symptoms of both Obsessive-Compulsive Disorder and Chronic Phonic Tic Disorder, and both diagnoses may be assigned if the diagnostic requirements for each are met.