J B Nissen1,2, A H Carlsen3, P H Thomsen3,4. 1. Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark. judiniss@rm.dk. 2. Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark. judiniss@rm.dk. 3. Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark. 4. Institute of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
Abstract
BACKGROUND: Chronic tic disorders are neurodevelopmental disorders that can be treated with Habit Reversal Training (HRT) and Exposure Response Prevention (ERP). Intermediate and long-term effects have been examined after individual treatment with HRT, whereas evaluation of long-term outcome after an initial treatment with ERP, or a combination of HRT and ERP is lacking. The present study examines the long-term effect after a combined treatment with HRT and ERP delivered in an individual or a group setting METHODS: Fifty-nine children and adolescents diagnosed with a chronic tic disorder were randomised to manualised treatment combining HRT and ERP as individual or group training. Forty-seven were re-examined 1 year after acute outcome. Outcome measures included Total Tic Severity score (TTS) measured by the Yale Global Tic Severity Scale (YGTSS) and Beliefs About Tics Scale (BATS) RESULTS: In a mixed model, it was shown that the initial improvement with both individual and group treatment was maintained throughout the follow-up period. There were no significant differences between the two methods of treatment delivery. Of all participants completing the 12 months evaluation, 74.4% were considered responders. There was a significant positive association between the reduction of TTS and the reduction in BATS. In a latent class post-treatment trajectory analysis, two classes were identified, where high baseline severity increased the likelihood of being in the lesser responder class. Similar, but only as a trend, having ADHD, planning difficulties or hypersensitivity increased the risk of a lesser response. CONCLUSIONS: The present study compares the efficacy in individualised and group treatment of providing manualised therapy for child and adolescent tic disorders using two behavioural methods (combined HRT and ERP) both of which have been shown to have acute benefits but only one of which has been validated for longer term effectiveness. In the present study, both individualised and group treatments showed benefit throughout a 1-year follow-up period with several potential confounds affecting outcomes, while the relative benefits of either HRT and ERP were not addressed. Trial registration NCT04594044, 1-10-72-216-15, registered 19th October 2020, retrospectively registered, https://register.clinicaltrials.gov/prs/app/template/Home.vm?uid=U0005BW2&ts=9&sid=S000ABEY&cx=-wlx7vb The study is approved by the National Ethical Committee (1-10-72-216-15) and the Danish Data Protection Agency (1-16-02-490-15), registered 12 October 2015.
RCT Entities:
BACKGROUND:Chronic tic disorders are neurodevelopmental disorders that can be treated with Habit Reversal Training (HRT) and Exposure Response Prevention (ERP). Intermediate and long-term effects have been examined after individual treatment with HRT, whereas evaluation of long-term outcome after an initial treatment with ERP, or a combination of HRT and ERP is lacking. The present study examines the long-term effect after a combined treatment with HRT and ERP delivered in an individual or a group setting METHODS: Fifty-nine children and adolescents diagnosed with a chronic tic disorder were randomised to manualised treatment combining HRT and ERP as individual or group training. Forty-seven were re-examined 1 year after acute outcome. Outcome measures included Total Tic Severity score (TTS) measured by the Yale Global Tic Severity Scale (YGTSS) and Beliefs About Tics Scale (BATS) RESULTS: In a mixed model, it was shown that the initial improvement with both individual and group treatment was maintained throughout the follow-up period. There were no significant differences between the two methods of treatment delivery. Of all participants completing the 12 months evaluation, 74.4% were considered responders. There was a significant positive association between the reduction of TTS and the reduction in BATS. In a latent class post-treatment trajectory analysis, two classes were identified, where high baseline severity increased the likelihood of being in the lesser responder class. Similar, but only as a trend, having ADHD, planning difficulties or hypersensitivity increased the risk of a lesser response. CONCLUSIONS: The present study compares the efficacy in individualised and group treatment of providing manualised therapy for child and adolescent tic disorders using two behavioural methods (combined HRT and ERP) both of which have been shown to have acute benefits but only one of which has been validated for longer term effectiveness. In the present study, both individualised and group treatments showed benefit throughout a 1-year follow-up period with several potential confounds affecting outcomes, while the relative benefits of either HRT and ERP were not addressed. Trial registration NCT04594044, 1-10-72-216-15, registered 19th October 2020, retrospectively registered, https://register.clinicaltrials.gov/prs/app/template/Home.vm?uid=U0005BW2&ts=9&sid=S000ABEY&cx=-wlx7vb The study is approved by the National Ethical Committee (1-10-72-216-15) and the Danish Data Protection Agency (1-16-02-490-15), registered 12 October 2015.
Authors: J Kaufman; B Birmaher; D Brent; U Rao; C Flynn; P Moreci; D Williamson; N Ryan Journal: J Am Acad Child Adolesc Psychiatry Date: 1997-07 Impact factor: 8.829
Authors: John Piacentini; Douglas W Woods; Lawrence Scahill; Sabine Wilhelm; Alan L Peterson; Susanna Chang; Golda S Ginsburg; Thilo Deckersbach; James Dziura; Sue Levi-Pearl; John T Walkup Journal: JAMA Date: 2010-05-19 Impact factor: 56.272
Authors: Tamara Pringsheim; Yolanda Holler-Managan; Michael S Okun; Joseph Jankovic; John Piacentini; Andrea E Cavanna; Davide Martino; Kirsten Müller-Vahl; Douglas W Woods; Michael Robinson; Elizabeth Jarvie; Veit Roessner; Maryam Oskoui Journal: Neurology Date: 2019-05-07 Impact factor: 9.910
Authors: Rachel Yates; Katie Edwards; John King; Olga Luzon; Michael Evangeli; Daniel Stark; Fiona McFarlane; Isobel Heyman; Başak İnce; Jana Kodric; Tara Murphy Journal: Behav Res Ther Date: 2016-03-23
Authors: Tamara Pringsheim; Michael S Okun; Kirsten Müller-Vahl; Davide Martino; Joseph Jankovic; Andrea E Cavanna; Douglas W Woods; Michael Robinson; Elizabeth Jarvie; Veit Roessner; Maryam Oskoui; Yolanda Holler-Managan; John Piacentini Journal: Neurology Date: 2019-05-07 Impact factor: 11.800