Article2013

Premonitory Urges in Adults With Complicated and Uncomplicated Tourette Syndrome

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Obsessive-Compulsive Spectrum Disorders Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Stuttering Research and Treatment

Abstract

Most patients with Tourette syndrome (TS) report experiencing subjective bodily sensations termed premonitory urges, before they have a tic. This study investigated relationships between premonitory urges and tic severity, depression, anxiety, obsessions, compulsions, and attention problems. We also explored possible differences between patients with and without comorbid conditions. Finally, we explored whether premonitory urges impacted on perceived quality of life (QoL). One hundred adult outpatients (70 males; mean age 32 years) were recruited from a specialist TS clinic. Fifty percent exhibited comorbid diagnoses, the most common of which were obsessive-compulsive disorder (23%), attention-deficit hyperactivity disorder (15%), anxiety (6%), and depression (5%). For the entire sample, premonitory urges were significantly related to clinical symptoms, especially obsessive-compulsive symptoms and anxiety, and were significantly negatively related to QoL scores. Premonitory urges had a strong negative correlation with QoL in patients with "pure" TS (no comorbidities), while this relationship was weaker for patients with comorbid conditions, who reported stronger or more frequent premonitory urges in association with greater anxiety. These findings may imply that slightly different psychological factors drive self-reported premonitory urge ratings in patients with and without comorbidities and that the perceived influence of distressing premonitory urges on wellbeing is less important in the context of comorbid symptomatology. As premonitory urges are related to QoL, they should be taken into account during evaluation of treatment efficacy, especially in cases with "pure" TS.

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References

1983The Hospital Anxiety and Depression Scale 2002The Obsessive-Compulsive Inventory: Development and validation of a short version.1989The Yale Global Tic Severity Scale: Initial Testing of a Clinician-Rated Scale of Tic Severity 1993Premonitory urges in Tourette's syndrome 2005Premonitory Urge for Tics Scale (PUTS)2009The Behavioral Spectrum of Gilles de la Tourette Syndrome 2003Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental aspects in children and adolescents 2008The Gilles de la Tourette Syndrome–Quality of Life Scale (GTS-QOL)

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2014Tourette syndrome and obsessive compulsive disorder: Compulsivity along the continuum 2016The premonitory urge revisited: An individualized premonitory urge for tics scale

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