• Journal of Oriental Neuropsychiatry
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• v.19 no.3
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• pp.219-229
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• 2008

Tics are sudden, painless, nonrhythmic behaviors that are either motor or vocal. As to DSM- VI diagnostic criteria, chronic tic disorder is either single or multiple motor or phonic tics, but not both, which are present for more than a year. In this case, a male patient was diagnosed tics disorder at 8 years old. He has suffered for 15 years and his symptom was simple motor tics of neck, both arms and both legs, not vocal tics. So we diagnosed him as the chronic tic disorder. The severity score headache was assessed using the Visual Analog Scales. The severity score tics was assessed at baseline using the Yale Global Tic Severity Scale (YGTSS) and we compared score of before with after treatment. We treated him with oriental medication( herbal medicine, acupuncture, cry cupping) and progressive muscle relaxation. After this treatment, chronic insomnia and extreme headache were disappeard and the symptoms of tics were mildly decreased.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.4
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• pp.91-98
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• 2022

Objectives: Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control. Methods: Thirty children with chronic tic disorder or Tourette's disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and post-intervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children's Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group. Results: The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group. Conclusion: The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.

• Journal of Oriental Neuropsychiatry
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• v.20 no.1
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• pp.119-146
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• 2009

Objectives : In this study, patients with tic disorders who visited an Oriental medicine clinic were examined for their demographic characteristics, characteristics of symptoms, relation to Attention-deficit Hyperactivity Disorder(ADHD) and peculiarity according to various variables such as motor and vocal tics. Methods : After surveying 292 patients who visited an Oriental medicine clinic with tic symptoms as main complaints for 17 months, SAS 9.1, a statistical program was used for statistical analysis. Results : 1. The BMI of male tic patients was significantly higher than female ones and it was similar to or higher than the normal group. 2. Patients who are eldest children were 1.7 times higher than those who are not eldest ones. 3. The most usual case of motor tics was the eye blink and the most one of vocal tics was a dry cough. 4. There was no significant difference between male and female patients for all symptoms of motor and vocal tics, but male patients had significantly more obsessions related to tics than female ones. 5. There was no significant difference in the age of initial occurrence of Transient tic disorder(TTD), Chronic tic disoder(CTD) and Tourette's disorder(TD). 6. For the general disorder of a tic and Conners' ADHD rating scale, there was no significance in TTD, CTD and TD. 7. 66% out of the total subjects of 197 cases were found to score more than 65 points in more than 1 items among 8 items such as the time, hearing, wrong alarm, mean response time and standard deviation in the response time, etc. of the ADHD diagnosis system(ADS). 8. The eye blink among motor tics was shown mainly by patients under 10 years old and the frown, movement of the head, shrug and movement of the arms were shown mainly by 11-19 years old patients. Conclusions : For the number, frequency, seriousness and inconvenience in life of tics, TD showed a significantly higher result than TTD and CTD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.2
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• pp.50-56
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• 2019

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.

• Journal of Oriental Neuropsychiatry
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• v.23 no.4
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• pp.69-94
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• 2012

Objectives : The goals of the present study are to assess children with tic disorders, their clinical characteristic and to prove the effectiveness of herbal treatments of tic disorders. Methods : The present study was conducted from January 2006 to April 2011, with 200 out-patient children between the age of 6 to 12 diagnosed with tic disorder (after excluding 10 children who could not be clearly diagnosed) at the "H'herbal medicine clinic located in Seoul. Of these 200 children, we have evaluated the epidemiology and clinical manifestation, and analyzed the results of herbal medicine treatments. Results : 1. Among the children diagnosed with tic disorder, TTD was most prevalent (43.3%) and males were more likely than females to express tics (5.45:1). Children with TD sought help significantly later (average age of 9.03 years) than the other types. 2. The analysis results of herbal medicine treatments are as follows. Compared to the pre-treatment assessment, children who received herbal medicine treatment for more than three months (n=52) showed a marked decrease in symptoms of motor tics (the number of motor tics, frequency, severity, complexity) and vocal tics (the number of vocal tics, frequency, severity), in the impairment level of combined tics (motor and vocal tics together) and in the overall score. Conclusions : In conclusion, we apprehended demographic and clinical characteristics of tic disorder patients who visited a Korean traditional medicine clinic by analyzing the psychological assessment results. Furthermore, we identified the effectiveness of herb formula in tic disorder.

• The Journal of Pediatrics of Korean Medicine
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• v.17 no.1
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• pp.141-155
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• 2003

Method : Chronic motor tic or vocal tic disorders are characterized which have one of the two kinds of tics for more than a year. It is characterized chronic motor tic or vocal tic disorders that have one of the two kinds of tics for more than a year. But Tourette's disorder is a disease which has one or more motor tics and vocal tics for more than a year. Contemporary empirical studies have suggested the rate of comorbid attention-deficit hyperactivity disorder(ADHD) or obsessive compulsive disorder(OCD) in children with tic disorders be high. Objects : As society is confusing, tic disorders are increasing. Therefore, determining the treatment strategy in children with tic disorders is very important. So we studied the literatures of traditional chinese medicine about tic disorders and reported the results. Results : The principals for medical treatment were So-gan(疏肝), I-gi(理氣), Sik-pung(熄風), Gin-kyung(鎭痙), Chung-oel(淸熱) etc. Medicines treatment is used more than acupuncture treatment. The herbs are used Uncariae ramulus et Uncus(釣鉤藤), Paeoniae Radix Alba(白芍藥), Poria(白茯岺), Glycyrrhizae Radix(甘草), Bupleuri Radi.x(柴胡), Fossilia ossis Mastodi(龍骨) etc. in the order named. Acupuncture points were used Naegwan(PC6), Shinmuin(HT7), P'ungnyur4(ST40), Paek'oe. (GV20), Chung-wan(CV12), Samumgye(SP6), Kongson(SP4), T'aech'ung(LR3) and so on.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.2
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• pp.27-34
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• 2022

Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.31 no.3
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• pp.146-153
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• 2020

Objectives: This study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS). Methods: Thirty-eight patients with Tourette's disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity. Results: The internal consistency of items on the PUTS was high, with a Cronbach's α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: "presumed functional relationship between the tic and the urge to tic," "the quality of the premonitory urge," and "just right phenomena." Conclusion: The results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.

• Journal of Oriental Neuropsychiatry
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• v.33 no.4
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• pp.361-376
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• 2022

Objectives: To understand experiences of daily life and Korean medicine treatment process and perspectives of caregivers caring for children with tic disorder. Methods: A semi-structured interview was conducted with caregivers of patients under 13 years who were experiencing Korean medicine treatment for tic disorder. A total of five participants were interviewed. The analysis was performed according to a four-step phenomenological method. Results: The following four components were derived from the experience of caring for children with tic disorder: general perception of tics, negative emotions caused by tics, social deprivation, and living with a child with tics. The following four components were derived from Korean medicine treatment experience for tic disorders: criteria for selecting treatment, awareness of Korean medicine, treatment experience in Korean medicine, and what needs to be improved. Conclusions: According to results of this study, caregivers caring for children with tic disorder experienced negative emotions such as frustration, guilt, and anxiety. They also experienced social deprivation such as stigma and prejudice. Korean medicine treatment can be an effective alternative for improving symptoms of tic disorders. The application of insurance benefits to Korean medicine is needed for patients and caregivers to autonomously choose treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.2
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• pp.51-62
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• 2021

Objectives: Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. Methods: The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. Results: Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. Conclusion: Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.