Network Analysis of Premonitory Urges, Tic Symptoms, Obsessive-Compulsive Symptoms, and Quality of Life in Drug-Naïve Children and Adolescents with Tic Disorder.

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.