Abstract
Purpose
Premonitory urges (PUs) are a growing area of interest for research on tic disorders. Understanding the contributions of urges to quality of life (QoL) is important. This study explores the relationships among PUs, tic severity, and QoL in individuals with tic disorders (TDs).
Methods
Clinical data were collected from drug-naïve TD patients aged 6–16 years using the Yale Global Tic Severity Scale (YGTSS), the Premonitory Urge to Tic Scale (PUTS), and the Tourette-Quality of Life Scale (GTS-QOL). Patients were categorized into PU (PUTS > 9) and non-PU (NPU, PUTS = 9) groups. Logistic regression was used to analyze the influence of age and sex on the presence of PUs. Correlation and mediation analyses were performed.
Results
Among 1015 patients with PU and 259 without PU, significant differences (p < 0.05) were found in age, YGTSS scores, and overall GTS-QOL scores and its factors such as obsessive‒compulsive and psychological factors. No significant sex differences were observed (p = 0.291). Age was a significant predictor of PU presence (OR = 1.111, p < 0.001). Mediation analysis revealed that tic severity significantly mediated (p < 0.05) the relationship between PU and overall QoL, and this effect was evident across all YGTSS subscales.
Conclusions
PUs incidence in TD increases with age, correlating with higher tic severity and lower QoL. Tic severity mediates the PU-QoL relationship, but since the direct effect of PUs on QoL is the main factor, improving QoL requires greater attention to PUs over tic symptoms.