Wang Xianbin, Hong Xu, Ma Yihan, Xu Hui, Yu Liping, Zhang Wenyan, Jiang Zhongliang, Cui Yonghua, Li Ying
Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Healthy, Beijing, China.
Cloud Services Innovation Laboratory, Institute of Intelligent Science and Technology, China Electronics Technology Group Corporation, Beijing, China.
Child Psychiatry Hum Dev. 2025 Apr 16. doi: 10.1007/s10578-025-01838-y.
Premonitory urges (PU) in tic disorder (TD) are recognized as a crucial factor influencing tic symptoms and overall well-being. This study employs network analysis to explore the intricate relationships among PU, tic symptoms, obsessive-compulsive symptoms (OCS), and quality of life (QoL) in drug-naïve children and adolescents with TD. Participants were drug-naïve TD patients aged 6 to 16 years. All participants consented to undergo multiple accessments, including the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge to Tic Scale (PUTS), Gilles de la Tourette-Quality of Life Scale (GTS-QOL), Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), and Obsessive-Compulsive Inventory-Revised (OCI-R). Network analysis was conducted using the R-package qgraph. Based on a sample of 344 TD patients, robust associations were identified between PU and tic symptoms, OCS, and QoL deficits. Centrality analysis identified ordering symptoms and obsessive thoughts as key nodes. Notable cross-scale associations were observed, such as the connections between PU and checking symptoms, as well as PU and obsessive thoughts. Bridge centrality analysis revealed that obsessive thoughts were identified as the strongest bridge symptom. PU was indirectly related to QoL in individuals with TD, while OCS exerted a direct association. Our study underscores the role of OCS in tic-related symptoms among individuals with TD. Highlighting the significant associations between PU and OCS, it emphasizes the necessity for targeted interventions to improve overall well-being.
抽动障碍（TD）中的先兆冲动（PU）被认为是影响抽动症状和整体幸福感的关键因素。本研究采用网络分析方法，探讨初治TD儿童和青少年中PU、抽动症状、强迫症状（OCS）和生活质量（QoL）之间的复杂关系。研究对象为6至16岁的初治TD患者。所有参与者均同意接受多项评估，包括耶鲁全球抽动严重程度量表（YGTSS）、抽动先兆冲动量表（PUTS）、图雷特综合征生活质量量表（GTS-QOL）、儿童耶鲁-布朗强迫量表（CY-BOCS）和修订版强迫量表（OCI-R）。使用R包qgraph进行网络分析。基于344例TD患者的样本，发现PU与抽动症状、OCS和生活质量缺陷之间存在显著关联。中心性分析确定排序症状和强迫观念为关键节点。观察到显著的跨量表关联，如PU与检查症状以及PU与强迫观念之间的联系。桥接中心性分析显示，强迫观念被确定为最强的桥接症状。在TD患者中，PU与生活质量间接相关，而OCS则有直接关联。我们的研究强调了OCS在TD患者抽动相关症状中的作用。突出了PU与OCS之间的显著关联，强调了针对性干预以改善整体幸福感的必要性。
