Premonitory urges for tics in adult patients with Tourette syndrome

Eleanor Crossley, Stefano Seri, Jeremy S. Stern, Mary M. Robertson, Andrea E. Cavanna*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: Patients with Tourette syndrome (TS) often report characteristic sensory experiences, also called premonitory urges (PUs), which precede tic expression and have high diagnostic relevance. This study investigated the usefulness of a scale developed and validated in children and adolescents-the Premonitory Urge for Tics Scale (PUTS, Woods et al., 2005 [13])-for the assessment of PUs in adult patients with TS. Method: Standard statistical methods were applied to test the psychometric properties of the PUTS in 102 adult TS outpatients recruited from two specialist clinics in the United Kingdom. Results: The PUTS showed good acceptability and endorsement rates, with evenly distributed scores and low floor and ceiling effects. Item-total correlations were moderate to strong; PUTS total scores were significantly correlated with quantitative measures of TS severity. The PUTS showed excellent internal consistency reliability (Cronbach's alpha=0.85) and Spearman's correlations demonstrated satisfactory convergent and discriminant validity. Conclusions: Although originally devised to assess urges to tic in young patients with TS, the PUTS demonstrated good psychometric properties in a large sample of adults recruited at specialist TS clinics. This instrument is therefore recommended for use across the life span as a valid and reliable self-report measure of sensory experiences accompanying tic expression. © 2013 The Japanese Society of Child Neurology.

Original languageEnglish
Pages (from-to)45-50
Number of pages6
JournalBrain and Development
Issue number1
Early online date29 Jan 2013
Publication statusPublished - Jan 2014


  • adult
  • premonitory urges
  • psychometric properties
  • PUTS
  • tics
  • tourette syndrome


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