J Korean Acad Child Adolesc Psychiatry.  2019 Apr;30(2):50-56. 10.5765/jkacap.180025.

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

• Nam SH
• Park J
• Park TW

• KMID: 2448878
• DOI: http://doi.org/10.5765/jkacap.180025

Abstract

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.

Keyword

Behavior therapy; Comorbidity; Drug therapy; Premonitory urge; Tourette disorder

MeSH Terms

Anxiety Disorders
Behavior Therapy
Comorbidity
Drug Therapy
Humans
Obsessive-Compulsive Disorder
Tics
Tourette Syndrome*