Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
European Child & Adolescent Psychiatry
Erschienen in: European Child & Adolescent Psychiatry 1/2007

01.07.2007 | ORIGINAL CONTRIBUTION

Behavior therapy in tic-disorders with co-existing ADHD

verfasst von: Prof. Dr. Manfred Döpfner, Prof. Dr. Aribert Rothenberger

Erschienen in: European Child & Adolescent Psychiatry | Sonderheft 1/2007

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To give an overview concerning the behavioral treatment approaches for Chronic Tic Disorder (CTD) and Attention-Deficit/Hyperactivity Disorder (ADHD) and to provide some suggestions for the behavioral treatment of children and adolescents with a combination of both disorders.

Results

Pharmacotherapy plays an important role in the treatment of both ADHD and CTD. However, behavior therapy has also been proven to ameliorate the core symptoms of both disorders. The most prominent behavioral technique to reduce tics is habit reversal training. In ADHD behavioral interventions, especially parent training and behavioral interventions in preschool/school, are effective in reducing ADHD core symptoms and comorbid problems. In children and adolescents with ADHD plus CTD both ADHD and tic symptoms can be treated by behavioral interventions alone or in combination with pharmacotherapy. However, most of the published studies on behavioral interventions in children with ADHD or CTD do not give detailed information on comorbidity and many studies excluded patients with comorbid problems.

Conclusions

Clinical experience suggests that in CTD+ADHD success may be easier to achieve using behavioral treatment of ADHD first. Adherence to the habit reversal procedure to reduce tics in daily living is the most important problem in the behavioral treatment of tics especially in children with comorbid ADHD. Practical suggestions to overcome these difficulties are presented.
Literatur
1.
Abikoff H (1991) Cognitive training in ADHD children: less to it than meets the eye. J Learn Disabil 24:205–209PubMed
2.
Allen KD (1998) The use of an enhanced simplified habit-reversal procedure to reduce disruptive outbursts during athletic performance. J Appl Behav Anal 31:489–492PubMedCrossRef
3.
Azrin NH, Nunn RG (1973) Habit-reversal: a method of eliminating nervous habits and tics. Behav Res Ther 11:619–628PubMedCrossRef
4.
Azrin NH, Peterson AL (1988) Habit reversal for the treatment of Tourette syndrome. Behav Res Ther 26:347–351PubMedCrossRef
5.
Azrin NH, Peterson AL (1990) Treatment of Tourette syndrome by habit reversal: a waiting-list control group comparison. Behav Ther 21:305–318CrossRef
6.
Banaschewski T, Woerner W, Rothenberger A (2003) Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental aspects in children. Dev Med Child Neurol 45:700–703PubMedCrossRef
7.
Banaschewski T, Neale BM, Roessner V, Rothenberger A (2007) Comorbidity of tic disorders and ADHD – conceptual and methodological considerations. Eur Child Adolesc Psychiatry 16(Suppl 1): I/5–I/14
8.
Banaschewski T, Coghill D, Santosh P, Zuddas A, Asherson P, Buitelaar J, Danckaerts M, Döpfner M, Faraone SV, Rothenberger A, Sergeant J, Steinhausen HC, Sonuga-Barke EJS, Taylor E (2006) Long-acting medcations for the hyperkinetic disorders: a systematic review and European treatment guidelines. Eur Child Adolesc Psychiatry 15:476–498PubMedCrossRef
9.
Barkley RA (2006) Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. Guilford Press, New York
10.
Bergin A, Waranch HR, Brown J, Carson K, Singer HS (1998) Relaxation therapy in Tourette syndrome: a pilot study. Pediatr Neurol 18:136–142PubMedCrossRef
11.
Billings A (1978) Self-monitoring in the treatment of tics: a single-subject analysis. J Behav Ther Exper Psychiatry 9:339–342CrossRef
12.
Bohlhalter S, Goldfine A, Matteson S, Garraux G, Hanakawa T, Kansaku K, Wurzman R, Hallett M (2006) Neural correlates of tic generation in Tourette syndrome: an event-related functional MRI study. Brain 129:2029–2037PubMedCrossRef
13.
Carpenter LL, Leckman JF, Scahill L, McDougle C (1999) Pharmacological and other somatic approaches to treatment. In: Leckman JF, Cohen DJ (eds) Tourette’s syndrome–tics, obsessions, compulsions: developmental psychopathology and clinical care. John Wiley & Sons, New York, pp 370–397
14.
Carr JE (1995) Competing responses for the treatment of Tourette syndrome and tic disorders. Behav Res Ther 33:455–456PubMedCrossRef
15.
Carr JE, Chong IM (2005) Habit reversal treatment of tic disorders: a methodological critique of the literature. Behav Modif 29:858–875PubMedCrossRef
16.
Castellanos FX, Giedd JN, Elia J, Marsh WL, Ritchie GF, Hamburger SD, Rapoport JL (1997) Controlled stimulant treatment of ADHD and comorbid Tourette’s syndrome: effects of stimulant and dose. J Am Acad Child Adolesc Psychiatry 36:589–596PubMedCrossRef
17.
Cohen DJ, Bruun RD, Leckman JF (1988) Tourette’s syndrome and tic disorders: clinical understanding and treatment. Wiley, New York
18.
Connor DF (2006) Stimulants. In: Barkley RA (ed) Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. Guilford Press, New York, pp 608–647
19.
Doleys D, Kurtz P (1974) A behavioral treatment program for the Gilles de la Tourette syndrome. Psychol Reports 35:43–48
20.
Döpfner M, Breuer D, Schürmann S, Wolff Metternich T, Rademacher C, Lehmkuhl G (2004) Effectiveness of an adaptive multimodal treatment in children with Attention Deficit Hyperactivity Disorder – global outcome. Eur Child Adolesc Psychiatry 13(suppl 1):I/117–I/129
21.
Döpfner M, Schürmann S, Frölich J (2002) Therapieprogramm für Kinder mit hyperkinetischem und oppositionellem Problemverhalten (THOP). Beltz, Psychologie Verlags Union, Weinheim
22.
DuPaul GJ, Eckert TL (1997) The effects of school-based interventions for attention deficit hyperactivity disorder: a meta-analysis. School Psychol Rev 26:5–27
23.
DuPaul GJ, Stoner GD (2003) ADHD in the schools: assessment and intervention strategies. Guilford Press, New York
24.
Greenhill LL, Halperin JM, Abikoff H (1999) Stimulant medications. J Am Acad Child Adolesc Psychiatry 38:503–512PubMedCrossRef
25.
Greenhill LL, Pliszka S, Dulcan MK, Bernet W, Arnold V, Beitchman J, Benson RS, Bukstein O, Kinlan J, McClellan J, Rue D, Shaw JA, Stock S (2002) Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry 41:26S–49SPubMedCrossRef
26.
Heinrich H, Gevensleben H, Strehl U (2006) Annotation: Neurofeedback - train your brain to train behaviour. J Child Psychol Psychiatry 48:3–16CrossRef
27.
Himle MB, Woods DW (2005) An experimental evaluation of tic suppression and the tic rebound effect. Behav Res Ther 43:1443–1451PubMedCrossRef
28.
Hoekstra P, Anderson G, Troost P, Kallenberg C, Minderaa R (2007) Plasma kynurenine and related measures in tic disorder patients. Eur Child Adolesc Psychiatry 16(Suppl 1):I/71–I/77
29.
Hoogduin K, Verdellen CW, Cath DC (1997) Exposure and response prevention in the treatment of Gilles de la Tourette’s syndrome: four case studies. Clin Psychol Psychotherapy 4:125–135CrossRef
30.
Houlihan D, Hofschulte L, Patten C (1993) Behavioral conceptualizations and treatments of Tourette’s syndrome: A review and overview. Behav Res Treatment 8:111–131
31.
King R, Scahill L, Findley D, Cohen DJ (1999) Psychosocial and behavioral treatments. In: Leckman JF, Cohen DJ (eds) Tourette’s syndrome–tics, obsessions, compulsions: developmental psychopathology and clinical care. John Wiley & Sons, New York, pp 338–359
32.
Kirov R, Banaschewski T, Uebel H, Kinkelbur J, Rothenberger A (2007) REM-sleep alterations in children with co-existence of tic disorder and attention-deficit/hyperactivity disorder: impact of hypermotor symptoms. Eur Child Adolesc Psychiatry 16(Suppl 1): I/45–I/50
33.
Leckman J, Vaccarino F, Kalanithi P, Rothenberger A (2006) Annotation: Tourette syndrome: a relentless drumbeat – driven by misguided brain osciallations. J Child Psychol Psychiatry 47:537–550PubMedCrossRef
34.
Leckman JF, King R, Cohen DJ (1999) Tics and tic disorders In: Leckman JF, Cohen DJ (eds) Tourette’s syndrome–tics, obsessions, compulsions: developmental psychopathology and clinical care. John Wiley & Sons, New York, pp 23–42
35.
Leckman JF, Walker DE, Cohen DJ (1993) Premonitory urges in Tourette’s syndrome. Am J Psychiatry 150:98–102PubMed
36.
Long ES, Miltenberger RG (1998) A review of behavioral and pharmacological treatments for habit disorders in individuals with mental retardation. J Behav Ther Exp Psychiatry 29:143–156PubMedCrossRef
37.
Long ES, Miltenberger RG, Ellingson SA, Ott SM (1999) Augmenting simplified habit reversal in the treatment of oral-digital habits exhibited by individuals with mental retardation. J Appl Behav Anal 32:353–365PubMedCrossRef
38.
Miguel EC, do Rosario-Campos MC, Prado HS, do Valle R, Rauch SL, Coffey BJ, Baer L, Savage CR, O’Sullivan RL, Jenike MA, Leckman JF (2000) Sensory phenomena in obsessive-compulsive disorder and Tourette’s disorder. J Clin Psychiatry 61:150–156; quiz 157PubMedCrossRef
39.
Miller AL (1970) Treatment of a child with Gilles de la Tourette’s syndrome using behavior modification techniques. J Behav Ther Exp Psychiatry 1:319–321CrossRef
40.
Miltenberger RG, Fuqua RW (1985) A comparison of contingent vs non-contingent competing response practice in the treatment of nervous habits. J Behav Ther Exp Psychiatry 16:195–200PubMedCrossRef
41.
Miltenberger RG, Fuqua RW, McKiney T (1985) Habit reversal with muscle tics: replicaton and component analysis. Behav Therapy 16:39–50CrossRef
42.
MTA Study Group (1999) A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry 56:1073–1086CrossRef
43.
O’Connor KP, Brault M, Robillard S, Loiselle J, Borgeat F, Stip E (2001) Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders. Behav Res Ther 39:667–681PubMedCrossRef
44.
Ollendick TH (1981) Self-monitoring and self-administered overcorrection: the modification of nervous tics in children. Behav Modification 5:75–84CrossRef
45.
Pelham WE, Fabiano GA (2007) Empirically supported treatments for ADHD. J Clin Child Psychol (in press)
46.
Pelham WE Jr, Wheeler T, Chronis A (1998) Empirically supported psychosocial treatments for attention deficit hyperactivity disorder. J Clin Child Psychol 27:190–205PubMedCrossRef
47.
Peterson AL, Azrin NH (1992) An evaluation of behavioral treatments for Tourette syndrome. Behav Res Ther 30:167–174PubMedCrossRef
48.
Peterson AL, Azrin NH (1993) Behavioral and pharmacological treatments for Tourette syndrome: a review. Appl Prev Psychology 2:231–242CrossRef
49.
Peterson AL, Campise RL, Azrin NH (1994) Behavioral and pharmacological treatments for tic and habit disorders: a review. J Dev Behav Pediatr 15:430–441PubMedCrossRef
50.
Peterson BS, Pine DS, Cohen P, Brook JS (2001) Prospective, longitudinal study of tic, obsessive-compulsive, and attention-deficit/hyperactivity disorders in an epidemiological sample. J Am Acad Child Adolesc Psychiatry 40:685–695PubMedCrossRef
51.
Piacentini J, Chang S (2001) Beahvioral therapy for Tourette syndrome and tic disorders: state of the art. In: Cohen J, Jankovic J, Goetz C (eds) Advances in neurology, Vol. 85, Tourette syndrome. Lippincott Williams and Wilkins, Philadelphia, pp 319–332
52.
Piacentini J, Chang S (2005) Habit reversal training for tic disorders in children and adolescents. Behav Modification 29:803–822CrossRef
53.
Piacentini J, Chang S, Barrios V, McCracken J (2002) Habit reversal training for childhood tic disorders: a randomized controlled trial. In: Association for the Advancement of Behavior Therapy Meeting. Reno, NV
54.
Pierre CB, Nolan EE, Gadow KD, Sverd J, Sprafkin J (1999) Comparison of internalizing and externalizing symptoms in children with attention-deficit hyperactivity disorder with and without comorbid tic disorder. J Dev Behav Pediatr 20:170–176PubMed
55.
Plessen K, Royal J, Peterson B (2007) Neuroimaging of tic disorders with co-existing attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 16(Suppl 1):I/60–I/70
56.
Poncin Y, Sukhodolsky D, McGuireBA, Scahill MSN (2007) Drug and non-drug treatment of children with ADHD and tic disorders. Eur Child Adolesc Psychiatry 16(Suppl 1):I/78–I/88CrossRef
57.
Rapp JT, Miltenberger RG, Long ES (1998) Augmenting simplified habit reversal with an awareness enhancement device: preliminary findings. J Appl Behav Anal 31:665–668PubMedCrossRef
58.
Robertson MM (2006) Attention deficit hyperactivity disorder, tics and Tourette’s syndrome: the relationship and treatment implications. A commentary. Eur Child Adolesc Psychiatry 15:1–11PubMedCrossRef
59.
Robertson MM, Schnieden V, Lees AJ (1990) Management of Gilles de la Tourette syndrome using sulpiride. Clin Neuropharmacol 13:229–235PubMedCrossRef
60.
Roessner V, Becker A, Banaschewski T, Freeman RD, Rothenberger A (2007) Developmental psychopathology of children and adolescents with Tourette Syndrome – impact of ADHD. Eur Child Adolesc Psychiatry 16(Suppl 1):I/36–I/44
61.
Roessner V, Becker A, Banaschewski T, Rothenberger A (2007) Psychopathological profile in children with chronic tic disorder and co-existing ADHD: additive effects. J Abnorm Child Psychology 35:79–85CrossRef
62.
Roessner V, Robatzek M, Knapp G, Banaschewski T, Rothenberger A (2006) First-onset tics in patients with ADHD: impact of stimulants. Dev Med Child Neurol 48:616–621PubMedCrossRef
63.
Rothenberger A, Banaschewski T (2004) Informing the ADHD debate. Sci Am Mind 14:50–55
64.
Rothenberger A, Kostanecka T, Kinkelbur J, Cohrs S, Woerner W, Hajak G (2001) Sleep and Tourette’s syndrome. In: Cohen DJ, Jankovic J, Goetz C (eds) Tourette syndrome, advances in neurology, Vol. 85. Lippincott Williams and Wilkens, Philadelphia, pp 245–259
65.
Rothenberger A, Roessner V, Banaschewski T, Leckman JF (2007) Co-existence of tic disorders and attention-deficit/hyperactivity disorder – recent advances in unterstanding and treatment. Eur Child Adolesc Psychiatry 16(Suppl 1):I/1–I/4
66.
Sallee FR, Nesbitt L, Jackson C, Sine L, Sethuraman G (1997) Relative efficacy of haloperidol and pimozide in children and adolescents with Tourette’s disorder. Am J Psychiatry 154:1057–1062PubMed
67.
Scahill L, Chappell PB, King RA, Leckman JF (2000) Pharmacologic treatment of tic disorders. Child Adolesc Psychiatr Clin N Am 9:99–117PubMed
68.
Shapiro E, Shapiro AK, Fulop G, Hubbard M, Mandeli J, Nordlie J, Phillips RA (1989) Controlled study of haloperidol, pimozide and placebo for the treatment of Gilles de la Tourette’s syndrome. Arch Gen Psychiatry 46:722–730PubMed
69.
Sharenow E, Fuqua R, Miltenberger R (1989) The treatment of muscle tics with dissimilar competing response practice. J Appl Behav Analysis 22:35–42CrossRef
70.
Silva RR, Munoz DM, Daniel W, Barickman J, Friedhoff AJ (1996) Causes of haloperidol discontinuation in patients with Tourette’s disorder: management and alternatives. J Clin Psychiatry 57:129–135PubMed
71.
Spencer T, Biederman M, Coffey B, Geller D, Wilens T, Faraone S (1999) The 4-year course of tic disorders in boys with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 56:842–847PubMedCrossRef
72.
Steinhausen H, Novik T, Baldrusson G, Curatolo P, Lorenzo M, Pereira R, Ralston S, Rothenberger A, ADORE Study Group (2006) Co-existing psychiatric problems in ADHD in the ADORE cohort. Eur Child Adolesc Psychiatry 15(suppl 1):i25–i29CrossRefPubMed
73.
Task Force on Promotion, Dissemination of Psychological Procedures (1995) Task Force on Promotion and Dissemination of Psychological Training in and dissemination of empirically validated psychological treatments. Clin Psychologist 48:3–23
74.
Taylor E, Döpfner M, Sergeant J, Asherson P, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Rothenberger A, Sonuga Barke E, Steinhausen H-C, Zuddas A (2004) Clinical guidelines for hyperkinetic disorder – first upgrade. Eur Child Adolesc Psychiatry 13(suppl 1):I/7–I/30
75.
Turpin G (1983) The behavioral management of tic disorders: a critical review. Adv Behav Res Ther 5:203–245CrossRef
76.
Verdellen CW, Keijsers GP, Cath DC, Hoogduin CA (2004) Exposure with response prevention versus habit reversal in Tourettes’s syndrome: a controlled study. Behav Res Ther 42:501–511PubMedCrossRef
77.
Wilhelm S, Deckersbach T, Coffey BJ, Bohne A, Peterson AL, Baer L (2003) Habit reversal versus supportive psychotherapy for Tourette’s disorder: a randomized controlled trial. Am J Psychiatry 160:1175–1177PubMedCrossRef
78.
Woods DW, Miltenberger RG, Lumley VA (1996) Sequential application of major habit-reversal components to treat motor tics in children. J Appl Behav Anal 29:483–493PubMedCrossRef
79.
Wright KM, Miltenberger RG (1987) Awareness training in the treatment of head and facial tics. J Behav Ther Exp Psychiatry 18:269–274PubMedCrossRef
80.
Yordanova J, Heinrich H, Kolev V, Rothenberger A (2006) Increased event-related theta activity as a psychophysiological marker of comorbidity in children with tics and attention-deficit/hyperactivity disorders. Neuroimage 32:940–955PubMedCrossRef
Metadaten
Titel
Behavior therapy in tic-disorders with co-existing ADHD
verfasst von
Prof. Dr. Manfred Döpfner
Prof. Dr. Aribert Rothenberger
Publikationsdatum
01.07.2007
Erschienen in
European Child & Adolescent Psychiatry / Ausgabe Sonderheft 1/2007
Print ISSN: 1018-8827
Elektronische ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-007-1011-7

Weitere Artikel der Sonderheft 1/2007

European Child & Adolescent Psychiatry 1/2007 Zur Ausgabe

ORIGINAL CONTRIBUTION

Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome

ORIGINAL CONTRIBUTION

Executive functions in children with chronic tic disorders with/without ADHD: new insights

ORIGINAL CONTRIBUTION

REM-sleep alterations in children with co-existence of tic disorders and attention-deficit/hyperactivity disorder: impact of hypermotor symptoms

OriginalPaper

Co-existence of tic disorders and attention-deficit/hyperactivity disorder

ORIGINAL CONTRIBUTION

Neuroimaging of tic disorders with co-existing attention-deficit/hyperactivity disorder

ORIGINAL CONTRIBUTION

Developmental psychopathology of children and adolescents with Tourette syndrome – impact of ADHD

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise