The relationship between premonitory urges, interoceptive sensibility, alexithymia, psychological problems and tic severity in adolescents with tic disorders

Recent evidence suggests that tic symptoms and premonitory urges may be related to altered interoceptive processing. However, the relationship between interoceptive sensibility, alexithymia, psychological problems, and tic severity remains underexplored, particularly in adolescents. The aim of our study was to determine the relationship between premonitory urges, interoceptive sensibility, alexithymia, psychological problems, and tic severity in adolescents with tic disorders. This cross-sectional study included 46 adolescents diagnosed with tic disorders and 42 healthy controls, aged 11–17 years, who applied to a city hospital child and adolescent psychiatry outpatient clinic between July 2024 and December 2024. Participants were evaluated with the Yale Global Tic Severity Scale (YGTSS), Premonitory Urges for Tics Scale (PUTS), Alexithymia Questionnaire for Children (AQC), Multidimensional Assessment of Interoceptive Awareness in Youth (MAIA-Y), and Strengths and Difficulties Questionnaire (SDQ). We used the SPSS Statistics 23.0 program and R (version 4.1.1) for analysis. p < 0.050 was accepted as the significance level. Adolescents with tic disorders showed elevated levels of alexithymia and psychological problems and demonstrated different patterns of interoceptive sensibility in comparison to controls. Alexithymia and psychological problems were positively correlated with the severity of tics, whereas capacity to listen to and trust the body was negatively correlated. No statistically significant association was found between premonitory urges and tic severity. According to multiple linear regression analysis, the total score of the YGTSS increases by 4.329 units with a 1-unit increase in the SDQ emotional symptoms score. A 1-unit increase in the body listening subscale score of MAIA-Y decreases the total score of YGTSS by 3.494 units. Adolescents with tic disorders may have different characteristics compared to controls in terms of alexithymia, psychological problems, and interoceptive sensibility, and that tic severity may be related to emotional symptoms and body listening capacity.