A Randomized Controlled Trial Comparing Behavioral, Educational, and Pharmacological Treatments in Youths With Chronic Tic Disorder or Tourette Syndrome

Rizzo, Renata; Pellico, Alessandra; Silvestri, Paola R.; Chiarotti, Flavia; Cardona, Francesco

doi:10.3389/fpsyt.2018.00100

Cited by 64 publications

(41 citation statements)

References 32 publications

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“…In this study, we found evidence to support the e cacy of ERP for reducing obsession-compulsion and tic symptoms. Behavioral therapy and SRIs were found to be comparable in improving the symptoms in adults with OCD among three head-to-head RCTs [45], and ERP also exhibited comparable reductions in tic severity with habit reversal therapy (HRT) [46][47][48]. It appears that the mechanisms that underlie the treatment of OCD and tic disorders are similar to some extent.…”

Section: Meta-regression Analysismentioning

confidence: 89%

The efficacy of exposure and response prevention for Obsessive-Compulsive Disorder and Tourette Syndrome: A meta-analysis

Yan¹,

Wen²,

Yu³

et al. 2020

Preprint

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Background Exposure and response prevention (ERP) is a form of cognitive behavioral therapy (CBT) that can effectively relieve obsessive-compulsive symptoms and tic symptoms in patients with obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). However, the effect size of ERP is still unclear. Methods In this study, we performed a meta-analysis to identify the efficacy of ERP for individuals with OCD and TS. The standard mean difference (SMD) with a 95% confidence interval (CI) was calculated to assess the effect size of the efficacy for ERP. We used subgroup and meta-regression analysis to explore the heterogeneity of the pooled SMD of ERP for OCD. Results A total of 17 studies including a total of 926 patients with OCD and 66 patients with TS were identified. We observed a small-to-medium effect size of ERP for both OCD (SMD = -0.21, 95% CI: -0.47 to 0.06) and TS (SMD = -0.26, 95% CI: -0.75 to 0.22). Conclusions In conclusion, we found that ERP is effective for patients with OCD and TS. We suggest a combination with other therapies and the development of online ERP services that might prove a promising new direction for healthcare providers.

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Section: Meta-regression Analysismentioning

confidence: 89%

The efficacy of exposure and response prevention for Obsessive-Compulsive Disorder and Tourette Syndrome: A meta-analysis

Yan¹,

Wen²,

Yu³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Another randomized clinical trial concluded that behavioural therapy, including HRT, is as effective as pharmacological therapy in the treatment of tic disorders in children and adolescents (Rizzo, Pellico, Silvestri, Chiarotti, & Cardona, 2018). New guidelines released by the American Academy of Neurology recommend CBIT as the first-line treatment for patients with symptoms that interfere with daily activities (Pringsheim et al, 2019).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Recent randomized clinical trials have confirmed the effectiveness of CBIT in treating children and adults with TS and CTDs (Abramovitch et al, ; Deckersbach, Rauch, Buhlmann, & Wilhelm, ; Piacentini et al, ; Storch et al, ; Wilhelm et al, ). Another randomized clinical trial concluded that behavioural therapy, including HRT, is as effective as pharmacological therapy in the treatment of tic disorders in children and adolescents (Rizzo, Pellico, Silvestri, Chiarotti, & Cardona, ). New guidelines released by the American Academy of Neurology recommend CBIT as the first‐line treatment for patients with symptoms that interfere with daily activities (Pringsheim et al, ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a modified comprehensive behavioral intervention for tics for children and adolescents with tourette's syndrome: A randomized controlled trial

Wang

Chang

Hsueh

2020

Journal of Advanced Nursing

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Aim To evaluate the effectiveness of a modified four‐session Comprehensive Behavioral Intervention for Tics programme for decreasing tics in children and adolescents with Tourette's syndrome. Background Comprehensive Behavioral Intervention for Tics programme has been shown to decrease tic severity. However, the lack of behaviour therapists in countries, such as in Taiwan, may preclude application of the standard eight‐session, 10‐week programme. Design Randomized controlled study. Methods Participants aged 6–18 years diagnosed with Tourette's syndrome or chronic tic disorder were recruited from February 2015 through September 2016. Participants in the control and intervention groups (N = 23 each) received the routine care (daily pyridoxine [50 mg] and psychoeducation). The intervention group received additional four behavioural intervention sessions over a 3‐month period that included psychoeducation, habit reversal training, relaxation training, and education on tic relapse prevention. The outcome measures, Yale Global Tic Severity Scale scores, were assessed at before and after the completion of programme for both groups and again at 3 months follow‐up for the intervention group. The effect of the intervention on severity scores was assessed using a generalized estimated equation. Results Comparison of scores before and after intervention showed that the intervention significantly decreased the severity of total motor tics (B = −3.28, p < .01) and total tics (B = −5.86, p < .01) as compared with control treatment. YGTSS scores for the intervention group were lower at 3‐month follow‐up as compared with before treatment or immediately after treatment completion (total tics, p < .001). Conclusion The modified four‐session Comprehensive Behavioral Intervention for Tics programme was more effective than routine care for decreasing tic severity in our cohort of 6‐ to 18‐year olds. This improvement was maintained 3 months after intervention. Impact Healthcare providers, including nurses, in countries currently not adopting Comprehensive Behavioral Intervention for Tics programme should be made aware of the positive effects of this modified intervention for Tourette's syndrome.

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“…However, no studies have directly compared CBIT vs. medication. The closest approximation is a study in Italy that compared a package of behavior therapy for tics (combining CBIT and exposure therapy) to antipsychotic medication and to psychoeducation (Rizzo et al, 2018). Results showed that behavior therapy and antipsychotic medication were equally effective in reducing tic severity, and both were superior to psychoeducation.…”

Section: How Does Cbit Compare To Other Treatments For Tics?mentioning

confidence: 99%

Treating Tourette Together: An Agenda for Patient-Centered Research Focused on Comprehensive Behavior Therapy for Tics

Conelea¹,

Bennett²,

Capriotti³

et al. 2020

Preprint

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After the Summit, we organized this input into 4 Key Research Areas that described the general types of research that attendees felt passionately about.Here, we list these domains, as well as specific Research Questions within each domain. Even though we number these below, each is considered equally important (for example, #3 isn't a lower priority than #1). Key Research Domains and Sample Questions Domain 1: Increasing Access to CBIT Representative research questions include:1. Children spend a lot of time in school. Can we train school-based providers (e.g., guidance counselors, school OTs) to provide CBIT effectively in school settings?2. Currently, there are not enough CBIT providers for all of the people with TDs who want CBIT. What are the most effective ways to train more providers in CBIT?3. Many people with TDs have to see more than one doctor, or wait a long time to get diagnosed and connected to quality care. What is the best way to train general doctors (such as pediatricians and family doctors) to recognize TDs and provide appropriate education, resources, treatment recommendations, and referrals? Domain 2: Increasing CBIT's EffectivenessRepresentative research questions include:1. CBIT in its current form does not work for everyone. Can we improve CBIT outcomes by figuring out what makes it work more, or less, well for some people? This would include looking at numerical information from studies, and also talking with people who have received CBIT about ways to improve it.2. CBIT involves a number of different parts. Can we make CBIT more efficient by identifying its most "active ingredients"?3. Many people with TDs do not feel that CBIT is a good fit for them. Can we create a "CBIT Readiness Interview" to explain what CBIT is, discuss concerns, and possibly increase patients' desire to do CBIT? Domain 3: Optimizing How CBIT Fits into Individuals' Broader Care for TDsRepresentative research questions include:1. People with TDs are likely to use multiple kinds of treatments, such as medications and CBIT. What are the best sequences of treatment for TDs (for example, CBIT followed by medication, or vice versa)? And, can we identify who will benefit from one treatment sequence instead of another?2. Many patients who want CBIT have to wait a long time on waitlists to get it. Can we help people with TDs find relief more quickly by having them start with an online,selfhelp version of CBIT, and then move on to CBIT with a therapist if self-help is not effective for them?3. Many patients live too far from CBIT providers for weekly visits. Can we evaluate whether other CBIT formats work just as well, such as doing CBIT over videochat or doing a short, intensive "CBIT Bootcamp" (called "intensive outpatient treatment" by healthcare providers)?4. Many people with TDs take tic-reducing medications but wish they did not have to. Can CBIT be used as a tool to get off of these medications?5. How well does CBIT work compared to medication alone, and the combination of CBIT and medication used simultaneously? Full ...

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A Randomized Controlled Trial Comparing Behavioral, Educational, and Pharmacological Treatments in Youths With Chronic Tic Disorder or Tourette Syndrome

Cited by 64 publications

References 32 publications

The efficacy of exposure and response prevention for Obsessive-Compulsive Disorder and Tourette Syndrome: A meta-analysis

The efficacy of exposure and response prevention for Obsessive-Compulsive Disorder and Tourette Syndrome: A meta-analysis

Effectiveness of a modified comprehensive behavioral intervention for tics for children and adolescents with tourette's syndrome: A randomized controlled trial

Treating Tourette Together: An Agenda for Patient-Centered Research Focused on Comprehensive Behavior Therapy for Tics

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