Premonitory Urges in Adults With Complicated and Uncomplicated Tourette Syndrome.
A single question about urge strength tells you which adults with Tourette’s need urgent help for anxiety, OCD, and low life satisfaction.
01Research in Context
What this study did
The team asked the adults with Tourette Syndrome to fill out three short surveys.
They split the group: 30 had only Tourette’s, 30 also had OCD, ADHD, or anxiety.
Each adult rated how strong their premonitory urges felt and how good their life felt.
What they found
Stronger urges went hand-in-hand with worse OCD and anxiety symptoms.
The same adults also said their quality of life was lower.
The link was sharpest in the “pure” Tourette group—no extra diagnoses.
How this fits with other research
Golubović et al. (2013) also measured quality of life, but in teens with ID. They found parents and kids disagreed on the scores. Whitehouse et al. (2014) shows why both voices matter: self-reported urges still predict life quality even when no parent is asked.
Dinya et al. (2012) surveyed Hungarian teens with dual diagnosis and saw more problem behaviors as IQ dropped. Whitehouse et al. (2014) flips the lens: in adults with Tourette’s, it is not IQ but the urge level that tracks distress.
Wilde et al. (2017) mapped self-injury and aggression in adults with tuberous sclerosis. Both studies flag that adult neurodevelopmental clinics must screen for hidden pain—here urges, there self-harm—to guide support plans.
Why it matters
If you serve adults with Tourette’s, add one quick urge-rating scale to your intake. A high score is a red flag for untreated OCD or anxiety and a clear sign that quality-of-life goals should move to the front of the plan.
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02At a glance
03Original 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.
Behavior modification, 2014 · doi:10.1177/0145445513504432