Nam Seok Hyun, Park Juhyun, Park Tae Won
Department of Psychiatry, College of Medicine, Chonbuk National University, Jeonju, Korea.
College of Medicine, Seoul National University, Seoul, Korea.
Soa Chongsonyon Chongsin Uihak. 2019 Mar 31;30(2):50-56. doi: 10.5765/jkacap.180025.
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.
大多数患有图雷特氏症的患者在出现抽搐之前会立即经历一种不舒服的感觉现象，称为先兆冲动。有人提出，先兆冲动与强迫症、焦虑症和注意力缺陷多动障碍等共病有关，尽管这些关联并不一致。大多数患者由于先兆冲动而出现抽搐，抽搐发生后，大多数患者报告先兆冲动会暂时缓解。因此，几项研究评估了先兆冲动及其潜在的治疗效用。基于先兆冲动诱发抽搐的概念，已经开发了诸如暴露与反应预防和习惯逆转疗法等行为治疗方法。然而，这些疗法的主要机制——习惯化是否与它们的有效性直接相关仍不清楚。此外，药物治疗对先兆冲动的观察效果也不一致。
