Relationships among Tic Symptoms, Expressed Emotions, and Quality of Life in Tic Disorder Patients

  • Hojun Lee
  • Soyoung Park
  • Jongha Lee
  • Moon-Soo LeeEmail author
Original Paper



Tic disorder is a chronic disease seen in children and adolescents that considerably affects quality of life. Of the many factors affecting quality of life in tic disorder patients, their families’ emotional relatedness and responses are important determinants; we used “expressed emotions” to identify this.


A total of 56 patients aged 8–23 were enrolled. We used the Yale Global Tic Severity Scale (YGTSS) to assess tic symptoms, as well as the Family Questionnaire and the KIDSCREEN-52 to respectively evaluate expressed emotions in pediatric tic patients’ families and quality of life in tic patients. Children’s Depression Inventory (CDI) and State-Trait Anxiety Inventory for children (STAIC) were used for assessing severities of depression and anxiety. We then analyzed the correlations between these elements.


Levels of depression and anxiety, and severity of tic symptoms negatively affected quality of life in patients with tic disorder (CDI: r = −0.806, SAIC: r = −0.783, TAIC: r = −0.705). Expressed emotions also showed negative correlations with quality of life (r = −0.333). Considering each subscale of KIDSCREEN-52, we found that expressed emotions had negative correlations with subscale of moods and emotions (r = −0.426), autonomy (r = −0.288), social support and peers (r = −0.301), and school environment (r = −0.274).


Quality of life in children and adolescents with tic disorder could be improved further by focusing on and treating emotional distress and difficulties within their families.


Tourette’s disorder Tic Family climate Expressed emotion Quality of life 


Author Contributions

H.L.: designed and executed the study, analyzed the data and wrote the paper. S.P.: cooperated in the design and writing of the study. J.L.: performed the data analyses and wrote part of the results. M.S.L.: organized the total work for this study and edited the final manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the Korea University Hospital Institutional Review Board (IRB NO. 2015GR347). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

All participants were given a description of the study, and we obtained the informed consent of both the adolescent and two guardians.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Child and Adolescent Psychiatry, Department of PsychiatryKorea University Guro HospitalSeoulthe Republic of Korea
  2. 2.Department of Child and Adolescent PsychiatryWoorisoa Children’s HospitalSeoulthe Republic of Korea
  3. 3.Division of Child and Adolescent Psychiatry, Department of PsychiatryKorea University Ansan HospitalAnsanthe Republic of Korea

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