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

Wang, Huei Shyong; Chang, Hsiu Ju; Hsueh, Chang Wei

doi:10.1111/jan.14279

Cited by 24 publications

(22 citation statements)

References 40 publications

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“…Effect sizes were not reported Andrén et al (2019) [ 59 ] Internet ERP vs. Internet HRT N = 23 Age 8–16 YGTSS-TTS : Internet ERP: 23.8 (pre) to 18.3 (3FU) Within-group effect size: 1.12 Internet HRT: 23.5 (pre) to 20.2 (3FU) Within-group effect size: 0.50 12FU : YGTSS-TTS: Internet ERP: 16.9 Internet HRT: 19.4 Duration : 10 weeks of therapist-supported (via text messages) internet-delivered treatment Interventions : In addition to the ERP or HRT core elements, both groups included functional analysis and parent training Design : Study did not aim to compare groups Results : Significant within-group effect on the YGTSS-TTS for the Internet ERP group, but not the Internet HRT group Follow-up : Effects were maintained at 12FU Nissen et al (2019, 2021) [ 43 , 52 ] Individual HRT + ERP vs Group HRT + ERP N = 59 Age 9–17 YGTSS-TTS : Individual HRT + ERP: 23.8 (pre) to 14.3 (post) Within-group effect size: 1.21 Group HRT + ERP: 23.4 (pre) to 15.9 (post) Within-group effect size: 1.38 12FU : YGTSS-TTS: Individual HRT + ERP: 12.7 Group HRT + ERP: 12.8 Duration : 8 regular sessions and 1 booster session, delivered individually or in a group format Results : No significant between-group effect on the YGTSS-TTS. Significant within-group effects on the YGTSS-TTS for each group Follow-up : Treatment effects were maintained for both groups at 12FU Limitations : Uncertain whether the study was powered to detect significant between-group effects Chen et al (2020) [ 63 ] CBIT + UC vs. UC N = 46 Age 6–18 YGTSS-TTS : CBIT: 19.3 (pre) to 10.4 (post) UC: 17.7 (pre) to 14.5 (post) Between-group effect size: 0.56 3FU : YGTSS-TTS: CBIT: 6.6 Duration : CBIT: 4 sessions (during 3 months) Interventions : CBIT included psychoeducation, habit reversal training, relaxation training, and relapse prevention; UC included psychoeducation and 50 mg of pyridoxine (per day) Results : Significant between-group effect on the YGTSS-TTS (in favor of CBIT + UC) Follow-up : Further improvement for the CBIT + UC-group in a within-group ...…”

Section: Resultsmentioning

confidence: 99%

“…Chen et al evaluated the effects of a shortened CBIT-protocol (four instead of eight sessions). In a RCT [ 63 ], 46 participants (6–18 years) were randomized to shortened CBIT plus usual care (psychoeducation and 50 mg of pyridoxine) or usual care only. Results showed a medium-sized, significant between-group effect on the YGTSS-TTS (in favor of CBIT plus usual care; d =0.56).…”

Section: Resultsmentioning

confidence: 99%

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European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part II: psychological interventions

Andrén

Jakubovski

Murphy

et al. 2021

Eur Child Adolesc Psychiatry

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Part II of the European clinical guidelines for Tourette syndrome and other tic disorders (ECAP journal, 2011) provides updated information and recommendations for psychological interventions for individuals with tic disorders, created by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted to obtain original studies of psychological interventions for tic disorders, published since the initial European clinical guidelines were issued. Relevant studies were identified using computerized searches of the MEDLINE and PsycINFO databases for the years 2011–2019 and a manual search for the years 2019–2021. Based on clinical consensus, psychoeducation is recommended as an initial intervention regardless of symptom severity. According to a systematic literature search, most evidence was found for Habit Reversal Training (HRT), primarily the expanded package Comprehensive Behavioral Intervention for Tics (CBIT). Evidence was also found for Exposure and Response Prevention (ERP), but to a lesser degree of certainty than HRT/CBIT due to fewer studies. Currently, cognitive interventions and third-wave interventions are not recommended as stand-alone treatments for tic disorders. Several novel treatment delivery formats are currently being evaluated, of which videoconference delivery of HRT/CBIT has the most evidence to date. To summarize, when psychoeducation alone is insufficient, both HRT/CBIT and ERP are recommended as first-line interventions for tic disorders. As part of the development of the clinical guidelines, a survey is reported from ESSTS members and other tic disorder experts on preference, use and availability of psychological interventions for tic disorders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part II: psychological interventions

Andrén

Jakubovski

Murphy

et al. 2021

Eur Child Adolesc Psychiatry

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show abstract

“…For example, all eight CBIT sessions can be delivered over a small number of consecutive days (Blount et al, 2014). Additionally, one Taiwanese study showed adding a "light" version of CBIT (i.e., 4 sessions delivered across 3 months, with function-based intervention component omitted) to usual care led to greater reductions in tics and related impairment (Chen et al, 2019).…”

Section: Are There Differences Between Existing Cbit "Makes and Models"?mentioning

confidence: 99%

“…In some clinical practice settings (e.g., integrated primary care settings, managed care organizations), access to behavioral health services may be especially streamlined, creating a need to condense treatment into a smaller number of sessions than employed in research studies. There is some evidence that the streamlined, 4-session "CBIT light" can provide some benefit beyond usual care, though the extent of these benefits relative to traditional CBIT is unclear (Chen et al, 2019).…”

Section: How Do Cbit Formats Actually Work "In the Real World?"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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“…The prevalence rate if this syndrome is estimated as 0.77% in children in aged 6-15 years (9). This disorder can impact on quality of health and it is associated to other psychiatric condition and self-harm behaviours which emphasis the importance of appropriate treatment (10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Aripiprazole or Risperidone for Tourette’s Disorder in Children and Adolescents? Efficacy and Impact on Weight Comparative study of therapeutic efficacy and body mass index of risperidone and Aripiprazole in children and adolescents with Tourette’s syndrome

Soltanifar¹,

Lashkarnevis²,

Ziaee³

et al. 2021

PJMHS

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Introduction: Due to the high prevalence of Tourette’s disorder among children and adolescents and its negative consequences, an appropriate and effective medical treatment with minimal complications is necessary. Therefore, this study was conducted to compare the effects of Aripiprazole and Risperidone on Tourette’s disorders in both children and adolescents. Method: The statistical population of this clinical trial was children and adolescents aged from seven to eighteen years old. They were diagnosed with the Tourette’s disorders based on the DSM-V criteria by the clinical interview of a child and adolescent psychiatrist in the child Psychiatry clinic of Ibn-e-Sina's Psychiatric Hospital (Mashhad-Iran) in 2018. A total of forty participants were selected by the convenience sampling method, and they were randomly divided into two groups treated by medicines, named as Risperidone or Aripiprazole for two months. Then, the demographic information questionnaire was completed. The Y-GTSS Scale was completed. Clinical Effect Rating Scale (CGI-Tics Scale) was completed. Calculation of body mass index and medical side effects complications were completed. The evaluation was carried out both at the beginning and on second, fourth and eighth weeks, and the results were compared. The data were analyzed by SPSS software (version 14) through using descriptive statistics, chi-square, and variance analysis. Results: The two groups were homogeneous for demographic variables. There was no significant difference in BMI between the two groups. Despite the positive effect of both medicines, no significant difference was observed among the general scores of such disorders, the overall score of severity, Tourette’s recovery, and BMI of these two groups at the intervals and at the end of treatments. (p <0.05). Due to the low number of complications reported, statistical comparisons of the medical side effects were not done for us Conclusion: According to the results, it seems that the two medicines, Aripiprazole and Risperidone, were effective in improving the symptoms of Tourette’s disorders and its overall severity. However, there was no significant statistical differences between them. In terms of the medical side effects, the statistical comparison between the two medicines was not possible due to the small number of complications. Keywords: tic, Tourette’s syndrome, Aripiprazole, Risperidone

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

Cited by 24 publications

References 40 publications

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part II: psychological interventions

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part II: psychological interventions

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

Aripiprazole or Risperidone for Tourette’s Disorder in Children and Adolescents? Efficacy and Impact on Weight Comparative study of therapeutic efficacy and body mass index of risperidone and Aripiprazole in children and adolescents with Tourette’s syndrome

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