Behavior therapy linked to symptom remission in youth with tic disorders

In youth with Tourette syndrome and other persistent tic disorders, treatment with behavioral therapy was linked with symptom remission and a reduction in tic severity, according to a new study.

“Antipsychotic medications and the Comprehensive Behavioral Intervention for Tics are currently the treatment modalities with the most research support,” Flint M. Espil, PhD, clinical assistant professor at Stanford University School of Medicine, and colleagues wrote in the Journal of the American Academy of Child & Adolescent Psychiatry. “Several academic/professional bodies with an interest in the treatment of tic disorders recommend CBIT as the first-line intervention for individuals in need of treatment for [persistent tic disorders].”

Espil and colleagues aimed to determine long-term durability of Comprehensive Behavioral Intervention for Tics (CBIT) in youth with Tourette syndrome as well as those with persistent motor or vocal tic disorders.

Researchers followed up on a randomized, controlled trial of CBIT that included 126 participants, aged 9 to 17 years and diagnosed with persistent tic disorders, who received eight sessions over 10 weeks of either CBIT (n = 61) or supportive and educational treatment (n = 65).

From that original cohort, 80 participants (mean age, 22.7 years; 75% men) were recruited between March 2014 and January 2019, for a longitudinal follow-up and completed in-person or video interviews to determine current tic severity and tic-related impairment. Researchers used the Yale Global Tic Severity Scale (YGTSS) and the Clinical Global Impression of Severity (CGI-S) scale to assess participants.

Results showed that treatment responders to CBIT or supportive and educational therapy in the original trial achieved partial, but not full, tic remission. Severity of tics also significantly decreased in the group, with 40% of participants reporting partial remission.

Behavior therapy responders (n = 21) in the original trial were more likely (67%) to achieve remission at follow-up (Total Tic Score = 12.52; SD = 10.75) compared with psychoeducation/supportive therapy responders (n = 6; 0%) at follow-up (Total Tic Score = 20.67; SD = 6.92) on the YGTSS. Data additionally revealed tic-related impairment decreased, with no significant differences among treatment groups or responders.

“Further efforts should be undertaken by researchers, clinicians and organizations with knowledge of [persistent tic disorders] to promote awareness and accessibility of CBIT,” Espil and colleagues wrote.