Introduction
Method
Results
Evidence-based psychological interventions
Study | Groups | Subjects | Efficacy | Follow-up | Comments |
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Verdellen et al. (2004) [9] | HRT vs ERP | N = 43 Age 7–55 | YGTSS-TTS: HRT: 24.1 (pre) to 19.7 (post) Within-group effect size: 1.06 ERP: 26.2 (pre) to 17.6 (post) Within-group effect size: 1.42 | 3FU: YGTSS-TTS: HRT: 13.5 ERP: 14.0 | Duration: HRT: 10 sessions (1 h, weekly); ERP: 12 sessions (2 h, weekly) Results: No significant between-group effect on the YGTSS-TTS. Significant within-group effects on the YGTSS-TTS for each group Follow-up: Treatment effect maintained for both groups Limitations: Uncertain whether the study was powered to detect significant between-group effects. 3FU included 25 participants who had been crossed over to the other group |
Piacentini et al. (2010) [8] | CBIT vs PST | N = 126 Age 9–17 | YGTSS-TTS: CBIT: 24.7 (pre) to 17.1 (post) PST: 24.6 (pre) to 21.1 (post) Between-group effect size: 0.68 | 6FU: CBIT: 20 out of 23 available initial treatment responders were still classified as treatment responders (according to the CGI-I) | Duration: 8 sessions (during 10 weeks; first two sessions 1.5 h, remaining sessions 1 h). 3 monthly booster sessions for responders Interventions: CBIT included psychoeducation about tic disorders, HRT, relaxation training, and functional analysis; PST included psychoeducation and supportive psychotherapy Results: Significant between-group effect on the YGTSS-TTS (in favor of CBIT) Follow-up: Treatment effects were maintained Limitations: Follow-up data were only available for initial treatment responders |
Himle et al. (2012) [54] | F2F CBIT vs VC CBIT | N = 20 Age 8–17 | YGTSS-TTS: F2F CBIT: 24.1 (pre) to 17.6 (post) VC CBIT: 23.4 (pre) to 15.6 (post) | 4FU: YGTSS-TTS: F2F CBIT: 20.1 VC CBIT: 16.8 | Duration: 8 sessions (weekly) via a VC software Interventions: CBIT included psychoeducation about tic disorders, HRT, relaxation training, and functional analysis Results: No significant between-group effect on the YGTSS-TTS. Significant within-group effects on the YGTSS-TTS for each group Follow-up: Significant within-group effect from pre to 4FU for the combined sample Limitations: Uncertain whether the study was powered to detect significant between-group effects |
Wilhelm et al. (2012) [15] | CBIT vs PST | N = 122 Age 16–69 | YGTSS-TTS: CBIT: 24.0 (pre) to 17.8 (post) PST: 21.8 (pre) to 19.3 (post) Between-group effect size: 0.57 | 6FU: CBIT: 12 out of 15 available initial treatment responders were still classified as treatment responders (according to the CGI-I) | Duration: 8 sessions (during 10 weeks; first two sessions 1.5 h, remaining sessions 1 h). 3 monthly booster sessions for responders Interventions: CBIT included psychoeducation about tic disorders, HRT, relaxation training, and functional analysis; PST included psychoeducation and supportive psychotherapy Results: Significant between-group effect on the YGTSS-TTS (in favor of CBIT). Significantly higher proportion of treatment responders in the CBIT group (24 vs. 4), as measured by the CGI-I Follow-up: Treatment effects were maintained Limitations: Follow-up data were only available for initial treatment responders |
McGuire et al. (2015) [22] | LWT vs Waitlist | N = 24 Pediatric sample | YGTSS-TTS: LWT: 20.2 (pre) to 14.3 (post) Waitlist: 24.7 (pre) to 24.8 (post) YGTSS Impairment Score: LWT: 27.5 (pre) to 8.3 (post) Waitlist: 31.7 (pre) to 23.8 (post) Between-group effect size: 1.50 | 1FU: 1FU was completed for 5 out of 10 initial treatment responders (according to the CGI-I). No change was found between the post and 1FU YGTSS Impairment scores, indicating maintenance of the treatment effects | Duration: 10 sessions (weekly) Interventions: LWT included abbreviated HRT, cognitive restructuring, problem solving, parent training, emotion regulation, overcoming tic-related avoidance, talking about tics with peers and coping at school, and improving self-esteem Results: Significant between-group effect on the YGTSS Impairment score (primary outcome) (in favor of LWT). No significant between-group effect on the YGTSS-TTS, but significant within-group effect for the LWT group on the same measure Follow-up: Treatment effects were maintained Limitations: Follow-up data were only available for initial treatment responders |
Ricketts et al. (2016) [55] | VC CBIT vs Waitlist | N = 20 Age 8–16 | YGTSS-TTS: VC CBIT: 25.8 (pre) to 18.5 (post) Waitlist: 22.0 (pre) to 20.3 (post) Between-group effect size: 0.15 (partial η2) | FU: N/a | Duration: 8 sessions (during 10 weeks; first two sessions 1.5 h, remaining sessions 1 h) via a VC software Interventions: CBIT included psychoeducation about tic disorders, HRT, relaxation training, and functional analysis Results: Significant between-group effect on the YGTSS-TTS (in favor of VC CBIT) |
Group HRT vs Group PE | N = 33 Age 9–13 | YGTSS-TTS: N/a YGTSS-MTSS: Group HRT: 17.7 (pre) to 15.1 (post) Group PE: 16.3 (pre) to 15.9 (post) Between-group effect size: 0.55 | 12FU: YGTSS-MTSS: Group HRT: 12.2 Group PE: 13.8 | Duration: 8 sessions (first two sessions 1.5 h, remaining sessions 1 h) delivered in a group format Results: Significant between-group effect on the YGTSS-MTSS (in favor of Group HRT) Follow-up: Both groups combined improved significantly on the YGTSS-TTS and the YGTSS-MTSS between pre and 12FU Limitations: YGTSS-TTS were not reported at pre and post | |
Seragni et al. (2018) [19] | HRT vs UC | N = 21 Pediatric sample | YGTSS-TTS: N/a | 3FU: YGTSS-MTSS: Significant within-group effect for HRT and UC combined into one group. Scores n/a | Duration: HRT: 8 sessions (during 10 weeks); UC: 3 sessions (during 10 weeks) Results: No significant between-group effect on any reported YGTSS score Follow-up: Significant within-group effect for HRT and UC combined into one group Limitations: High number of dropouts, only 13 participants completed the trial. Uncertain whether the study was powered to detect significant between-group effects. Effect sizes were not reported |
Rizzo et al. (2018) [14] | BT vs. PE PT vs. PE BT vs. PT | N = 110 Age 8–17 | YGTSS-TTS: BT: 19.8 (pre) to 11.4 (post) PT: 24.1 (pre) to 15.7 (post) PE: 22.0 (pre) to 21.7 (post) | FU: YGTSS-TTS at 3 months post BT/PE and 5 months post initiation of PT: BT: 12.4 PT: 14.7 PE: 20.7 | Duration: 8 sessions (weekly, first two sessions 1.5 h, remaining sessions 1 h) Interventions: BT included HRT or ERP; PT included risperidone, aripiprazole or pimozide Results: Significant between-group effects on the YGTSS-TTS for BT vs. PE and PT vs. PE (in favor of BT and PT) Limitations: Uncertain whether the study was powered to detect significant between-group effects between BT and PT. 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 |
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 analysis at 3FU Limitations: No intention-to-treat analysis |
McGuire et al. (2020) [33] | HRT + DCS vs. HRT + placebo | N = 20 Age 8–17 | YGTSS-TTS: N/a | FU: N/a | Duration: HRT: 1 session Interventions: HRT; 50 mg of DCS or placebo. DCS was hypothesized to enhance the effect of HRT Results: Significant between-group effect on the Hopkins Motor/Vocal Tic Scale (in favor of HRT + DCS), for the two bothersome tics targeted in treatment Limitations: Did not use the YGTSS. Low dose of HRT compared to previous trials (only 1 session) |
Rachamim et al. (2020) [60] | Internet CBIT vs. Waitlist | N = 41 Age 7–18 | YGTSS-TTS: Internet CBIT: 22.7 (pre) to 16.1 (post) Waitlist: 21.9 (pre) to 20.9 (post) Between-group effect size: 0.20 (partial η2) | 6FU: YGTSS-TTS: Internet CBIT: 11.0 | Duration: 9 weeks of therapist-supported (via telephone) internet-delivered treatment + 6 monthly booster sessions Results: Significant between-group effect on the YGTSS-TTS (in favor of Internet CBIT) Follow-up: Large within-group effect for the Internet CBIT group at 6FU |
Singer et al. (2020) [56] | DVD HRT vs. HRT | N = 44 Age 7–13 | YGTSS-TTS: DVD HRT: 27.8 (pre) to 18.8 (post) HRT: 28.2 (pre) to 20.7 (post) | FU: N/a | Duration: HRT: 8 sessions (during 10 weeks) Interventions: DVD HRT-group received a DVD and written instructions on how to use HRT at home with the support of a parent; HRT-group received regular face-to-face HRT Results: No significant between-group effect. Significant within-group effects in both groups Limitations: Uncertain whether the study was powered to detect significant between-group effects. Large dropout rates and the lack of an intention-to-treat analysis make results difficult to interpret |
Zimmerman-Brenner et al. (2021) [51] | Group CBIT vs. Group PE | N = 61 Age 8–15 | YGTSS-TTS: Group CBIT: 24.8 (pre) to 39.8 (post) Group PE: 22.0 (pre) to 37.1 (post) | 3FU: YGTSS-TTS: Group CBIT: 18.4 Group PE: 21.8 | Duration: 8 weekly sessions (first two sessions 1.5 h, remaining sessions 1 h; considered the acute treatment phase) + 3 monthly 1-h booster sessions (during the follow-up phase). All sessions were delivered in a group format Results: No significant between-group effect. Significantly increased YGTSS-TTS in both groups (within-group analysis) at post-treatment, seemingly driven by increased vocal tic severity Follow-up: Significantly decreased YGTSS-TTS in both groups (within-group analysis) when comparing baseline to the 3-month follow-up Limitations: Uncertain whether the study was powered to detect significant between-group effects. No intention-to-treat analysis |