The severity of obsessive-compulsive symptoms in Tourette syndrome and its relationship with premonitory urges: a meta-analysis

ABSTRACT

Objectives

Nearly half of the patients with Tourette Syndrome (TS) present with comorbid Obsessive-Compulsive Symptoms (OCS) and premonitory urges (PUs). However, inconsistent results have been found in the correlation between PUs and OCS in patients with TS.

Methods

A meta-analysis was applied to identify the severity of OCS and its correlation with PUs in TS patients. Subgroup and meta-regression analyses were used to identify potential heterogeneity.

Results

A total of 13 studies, including 576 patients, were enrolled in this study. The pooled correlation coefficient (r) was 0.29 (95% confidence interval: 0.18, 0.38) and heterogeneity (I²) of pooled r was 40% based on a fixed-effect model. The mean level of OCS based on the assessment of Children’s Yale-Brown Obsessive-Compulsive Symptom Scale/Yale-Brown Obsessive-Compulsive Symptom Scale was 14.99 (95% CI: 11.41, 18.57) by a random effect model. Results of meta-regression analysis demonstrated that the severity of tic symptoms based on the assessment of the Yale Global Tic Severity Scale was the predictor of severity of OCS (p = 0.018).

Conclusion

There was a mild positive correlation between the PUs and OCS in patients with TS. The severity of OCS in TS patients was mild to moderate and positively predicted by the severity of tic symptoms.

KEYWORDS:

• Obsessive-compulsive symptoms
• premonitory urges
• Tourette syndrome
• correlation
• meta-analysis

Article highlights

• There is a mild correlation between the PUs and severity of OCS in patients with TS.

• The level of OCS severity in TS patients is likely to be mild to moderate.

• The severity of OCS in TS is predicted by the severity of tic symptoms.

• No heterogeneity of the pooled r was found in the children subgroup, while high in the adults subgroup.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

A peer reviewer on this manuscript has received research support from the National Institute of Mental Health (NIMH), the Tourette Association of America (TAA), and the TLC Foundation for Body-Focused Repetitive Behaviors. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was funded by the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority.