• Title/Summary/Keyword: Premonitory urge

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Clinical Aspects of Premonitory Urges in Patients with Tourette's Disorder

  • Nam, Seok Hyun;Park, Juhyun;Park, Tae Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.2
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    • pp.50-56
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    • 2019
  • Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.

Development of the Korean Form of the Premonitory Urge for Tics Scale: A Reliability and Validity Study

  • Kim, Mira;Chung, Sang-Keun;Yang, Jong-Chul;Park, Jong-Il;Nam, Seok Hyun;Park, Tae Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.3
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    • pp.146-153
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    • 2020
  • Objectives: This study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS). Methods: Thirty-eight patients with Tourette's disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity. Results: The internal consistency of items on the PUTS was high, with a Cronbach's α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: "presumed functional relationship between the tic and the urge to tic," "the quality of the premonitory urge," and "just right phenomena." Conclusion: The results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.

Relationships Between Premonitory Urge, Tics and Comorbidities in Children and Adolescents With Chronic Tics (만성 틱장애 소아청소년의 전조충동, 틱증상 심각도, 동반질환 간의 관련성)

  • Joo-Han Kwon;Sang-Keun Chung;Jong-Chul Yang;Jong-Il Park;Ha-Min Kim;Tae Won Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.142-148
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    • 2023
  • Objectives : The purpose of this study is to investigate the relationships between premonitory urge, tic severity, and comorbidities in children and adolescents with chronic tic disorders. Methods : In this study, scales for tic symptoms, premonitory urge, obsessive-compulsive symptoms, and ADHD symptoms were repeatedly measured twice in 26 children and adolescents aged 10 to 18 years with chronic tic disorders. Correlations between scales were confirmed through repeated measures correlation analysis, and causal relationships between scales were confirmed through regression analysis using a linear mixed model. Results : The degree of premonitory urges showed a significant positive correlation with the severity of tic symptoms, the severity of obsessive-compulsive symptoms, and the severity of ADHD symptoms. The ADHD symptoms showed a significant positive correlation with the severity of tic symptoms. These results were the same even in children and adolescents with tic disorders who were not diagnosed with obsessive-compulsive disorder. Additionally, premonitory urges were found to have a significant positive effect on the severity of tic symptoms. Conclusions : These results may be helpful in treating tic disorders and can be used in future tic disorder research considering developmental trajectory.

The Clinical Effect of Botulinum Toxin in a Patient with Tourette's Syndrome: A Case Report and Review (뚜렛 증후군에서 보툴리눔 톡신의 임상 효과 : 증례보고 및 고찰)

  • Hyun, Jung Keun;Lee, Jun Hyung;Lee, Chang Min;Lim, Myung Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.2
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    • pp.90-95
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    • 2013
  • Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer's cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300mg of botulinum toxin in an 18-year-old patient with Tourette's disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette's disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.

Effects of Group Comprehensive Behavioral Intervention for Tics in Children With Tourette's Disorder and Chronic Tic Disorder

  • Kang, Na Ri;Kim, Hui-Jeong;Moon, Duk Soo;Kwack, Young Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.4
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    • pp.91-98
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    • 2022
  • Objectives: Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control. Methods: Thirty children with chronic tic disorder or Tourette's disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and post-intervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children's Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group. Results: The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group. Conclusion: The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.