Interoceptive Accuracy in Youth with Tic Disorders: Exploring Links with Premonitory Urge, Anxiety and Quality of Life

Tics are the hallmark feature of Tourette syndrome (TS), but psychiatric and sensory symptoms are widely prevalent and increasingly recognized as core manifestations of the disorder. Accumulating evidence suggests that these psychiatric and sensory symptoms exert greater influence on quality of life (QOL) than tics themselves. However, much remains uncertain about determinants of QOL in TS due to the complexity of the clinical presentation. Here, we sought to clarify the association between health-related QOL (HRQOL) and common psychiatric and sensory symptoms in adults with TS and other chronic tic disorders. To do so, we prospectively recruited 52 patients from a tertiary care clinic to complete self-report measures assessing HRQOL (Gilles de la Tourette-Quality of Life Scale, GTS-QOL), depression (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder Scale-7, GAD-7), obsessive-compulsive symptoms (Dimensional Obsessive-Compulsive Scale, DOCS), attention deficit hyperactivity disorder symptoms (Adult ADHD Self-Report Screening Scale for DSM-5, ASRS-V), and premonitory urge (Premonitory Urge to Tic Scale, PUTS). All participants were also administered the Yale Global Tic Severity Scale (YGTSS) to quantify tic severity. Using correlational analysis and multivariable linear regression modeling, we found that GTS-QOL score was significantly associated with scores from all other rating scales, with the exception of the PUTS. GTS-QOL was most strongly associated with PHQ-9, followed by ASRS-V, GAD-7, DOCS, and YGTSS total tic score. The regression model including these five independent variables, as well as sex, explained 79% of GTS-QOL score variance [F(6,40) = 29.6, p < 0.001]. Specific psychiatric symptoms differentially impacted physical, psychological, and cognitive HRQOL. Systematic assessment of psychiatric comorbidities is imperative for clinical care and clinical research efforts directed at improving QOL in adults with chronic tic disorders.

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The effects of Gilles de la Tourette syndrome and other chronic tic disorders on quality of life across the lifespan: a systematic review

European Child & Adolescent Psychiatry ◽

10.1007/s00787-016-0823-8 ◽

2016 ◽

Vol 25 (9) ◽

pp. 939-948 ◽

Cited By ~ 45

Author(s):

Joel Evans ◽

Stefano Seri ◽

Andrea E. Cavanna

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Tourette Syndrome ◽

Tic Disorders ◽

Chronic Tic Disorders

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The Clinical Neurology of Tourette Syndrome

CNS Spectrums ◽

10.1017/s1092852900011366 ◽

1999 ◽

Vol 4 (2) ◽

pp. 36-37,49-53 ◽

Cited By ~ 3

Author(s):

Gerald Erenberg

Keyword(s):

Quality Of Life ◽

Differential Diagnosis ◽

Adverse Effects ◽

Tourette Syndrome ◽

Short Duration ◽

Tic Disorders ◽

Pharmacologic Therapy ◽

Clinical Neurology ◽

Clinical Presentations

AbstractTic disorders may manifest in a wide variety of clinical presentations, ranging from single tics of relatively short duration to a series of complex tics that may last for years. An understanding of the etiology of various tic disorders is essential to establish a differential diagnosis of Tourette syndrome (TS). Because TS is incurable, improvement in quality of life is the primary goal of pharmacologic therapy. Although neuroleptics have been the most effective medications to date in managing the symptoms of TS, they may have significant adverse effects that limit their use. Several alternative pharmacologic options are either available or under investigation.

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Tic Disorders are Associated With Lower Child and Parent Quality of Life and Worse Family Functioning

Pediatric Neurology ◽

10.1016/j.pediatrneurol.2019.12.003 ◽

2020 ◽

Vol 105 ◽

pp. 48-54

Author(s):

Jennifer Vermilion ◽

Erika Augustine ◽

Heather R. Adams ◽

Amy Vierhile ◽

Adam B. Lewin ◽

...

Keyword(s):

Quality Of Life ◽

Family Functioning ◽

Tic Disorders ◽

Parent Quality Of Life

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Living with tics: Reduced impairment and improved quality of life for youth with chronic tic disorders

Psychiatry Research ◽

10.1016/j.psychres.2014.11.045 ◽

2015 ◽

Vol 225 (3) ◽

pp. 571-579 ◽

Cited By ~ 41

Author(s):

Joseph F. McGuire ◽

Elysse Arnold ◽

Jennifer M. Park ◽

Joshua M. Nadeau ◽

Adam B. Lewin ◽

...

Keyword(s):

Quality Of Life ◽

Tic Disorders ◽

Chronic Tic Disorders

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Social deficits in children with chronic tic disorders: Phenomenology, clinical correlates and quality of life

Comprehensive Psychiatry ◽

10.1016/j.comppsych.2013.04.009 ◽

2013 ◽

Vol 54 (7) ◽

pp. 1023-1031 ◽

Cited By ~ 33

Author(s):

Joseph F. McGuire ◽

Camille Hanks ◽

Adam B. Lewin ◽

Eric A. Storch ◽

Tanya K. Murphy

Keyword(s):

Quality Of Life ◽

Tic Disorders ◽

Social Deficits ◽

Clinical Correlates ◽

Chronic Tic Disorders

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Psychosocial Treatment to Improve Resilience and Reduce Impairment in Youth With Tics: An Intervention Case Series of Eight Youth

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.26.1.57 ◽

2012 ◽

Vol 26 (1) ◽

pp. 57-70 ◽

Cited By ~ 22

Author(s):

Eric A. Storch ◽

Jessica E. Morgan ◽

Nicole E. Caporino ◽

Lindsay Brauer ◽

Adam B. Lewin ◽

...

Keyword(s):

Quality Of Life ◽

Psychosocial Functioning ◽

Controlled Trial ◽

Case Series ◽

Psychosocial Treatment ◽

Tic Disorders ◽

Self Concept ◽

Tic Disorder ◽

Chronic Tic Disorder

Background: Many youth with tic disorders experience distress about having tics and how others may perceive them. Such symptoms are often more impairing and distressing than the tics themselves and negatively impact self-concept, psychosocial functioning, and quality of life. Objective: Although there exist pharmacological and behavioral treatments that target the frequency and severity of tics, no intervention has been developed specifically to help youth with tics cope with their condition and limit associated functional impairment and distress. With this in mind, we report an intervention case series of eight youth (ages 8–16 years) supporting the initial efficacy of a cognitive-behavioral therapy program entitled “Living with Tics” that promotes coping and resiliency among youth with tics. Method: Eight youth with a principal diagnosis of a tic disorder (i.e., Tourette syndrome [N = 6]; Chronic Tic Disorder [N = 2]) and associated psychosocial impairment participated. Assessments were conducted at screening, pretreatment, and posttreatment by trained raters. Treatment consisted of 10 weekly individual psychotherapy session focused on improving coping with having tics. Results: Six of eight youth were considered treatment responders. On average, participants exhibited meaningful reductions in tic-related impairment, anxiety, and overall tic severity as well as improvements in self-concept and quality of life. Conclusions: These data provide preliminary evidence for conducting a larger controlled trial to examine the utility of the Living with Tics psychosocial intervention for promoting adaptive functioning among youth with tics.

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Chronic tic disorders in children with ADHD

Archives of Disease in Childhood ◽

10.1136/archdischild-2017-314139 ◽

2018 ◽

Vol 103 (9) ◽

pp. 847-852 ◽

Cited By ~ 3

Author(s):

William Poh ◽

Jonathan M Payne ◽

Alisha Gulenc ◽

Daryl Efron

Keyword(s):

Quality Of Life ◽

Diagnostic Interview ◽

Tic Disorders ◽

Initial Assessment ◽

Tic Disorder ◽

Children With Adhd ◽

Teacher Screening ◽

Chronic Tic Disorder ◽

Externalising Disorders

ObjectiveTo examine in a community-based cohort: (1) the prevalence of chronic tic disorder (CTD) in children with attention-deficit/hyperactivity disorder (ADHD) compared with non-ADHD controls at ages 7 and 10; and (2) the additional psychiatric and functional burden of CTD in children with ADHD.MethodsChildren aged 6–8 years with ADHD (n=179) and controls (n=212) were recruited through 43 Victorian schools using parent and teacher screening surveys (Conners 3 ADHD Index), followed by case confirmation (Diagnostic Interview Schedule for Children-IV (DISC-IV)). CTD was identified using the DISC-IV categories chronic motor tic disorder, chronic vocal tic disorder or Tourette syndrome at baseline and 36-month follow-up. Internalising and externalising disorders, social functioning, academic performance and quality of life were also measured. Tests of proportions and independent t-tests were used to compare the ADHD+CTD group with sex-matched ADHD alone children.ResultsCompared with controls, children with ADHD were 4.1 (95% CI 1.1 to 14.1) times more likely to have CTD at age 7, and 5.9 (95% CI 1.6 to 17.9) times more likely at age 10. Children with ADHD+CTD experienced higher rates of internalising disorders and peer problems, and poorer quality of life than those with ADHD alone.ConclusionsCTD prevalence is higher in children with ADHD compared with controls, and confers substantial additional psychiatric and functional burden. Clinicians need to consider CTD in both the initial assessment and ongoing management of children with ADHD, and address both the symptoms and the associated impairments.

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Tic Disorders in Children with Epilepsy: Effect on Behavior and Quality of Life

QJM ◽

10.1093/qjmed/hcaa063.017 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

I A ELagouza ◽

S M Deifalla ◽

A Hossameldin

Keyword(s):

Quality Of Life ◽

Child Behavior Checklist ◽

Tic Disorders ◽

Idiopathic Epilepsy ◽

Total Quality ◽

Parent Rating ◽

Deviant Behaviors ◽

Group I ◽

Group Ii

Abstract Idiopathic Epilepsy in children is associated with several comorbidities. Tics and other deviant behaviors are some of them which could negatively impact the family quality of life. The current study aimed at comparing quality of life and behavioral test results in children with epilepsy and tics versus those with epilepsy only. Patients and Methods Sixty patients with idiopathic epilepsy aged from 4 to 18 years participated in the current study. Group I included 30 patients with idiopathic epilepsy and tic disorders aged 10.1+/-3.2 years and group II 30 with epilepsy only aged 10.1+/-3.1 years. The Arabic version of the Pediatric quality of life inventory 4.0 (PedsQLTM 4.0), the Arabic translation of the Child Behavior Checklist (CBCL) scores were used and Conner’s parent rating scale were used. The results were compared between the 2 participating groups. Results Group I patients had worse total quality of life scores for both the child’s and parent’s scores compared to group II patients (p<0.05). CBCL scores were significantly higher in group I regarding most of the internalizing and externalizing domains yet the total score was non-significantly higher in group I compared to group II (p=0.05). Group I patients had higher total Conner’s score compared to group II; (p=0.045). Furthermore, those with ADHD in group I was 70% compared to 50% in group II. Conclusion Tic disorders in the context of idiopathic epilepsy should be addressed seriously as they are associated with other behavioral defects that require intervention to achieve better quality of life.

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