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  • CBIT Adult & Child Studies

    Randomized Trial of Behavior Therapy for Adults with Tourettes Disorder
    Sabine Wilhelm, Ph.D., Alan L. Peterson, Ph.D., John Piacentini, Ph.D., Douglas W. Woods, Ph.D., Thilo Deckersbach, Ph.D., Denis G. Sukhodolsky, Ph.D., Susanna Chang, Ph.D., Haibei Liu, MPH, James Dziura, Ph.D., John T. Walkup, M.D., and Lawrence Scahill, M.S.N., Ph.D.

    Arch Gen Psychiatry. Author manuscript; available in PMC Sep 13, 2013.
    Published in final edited form as:
    Arch Gen Psychiatry. Aug 2012; 69(8): 795–803.
    doi: 10.1001/archgenpsychiatry.2011.1528

    This study is referenced in various articles on this Forum. For anyone interested in the complete text of the published paper it is attached to this post as a file
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    TouretteLinks Forum

  • #2
    Re: CBIT Adult & Child Studies

    Behavior Therapy for Children With Tourette Disorder

    A Randomized Controlled Trial
    John Piacentini, PhD; Douglas W. Woods, PhD; Lawrence Scahill, PhD, MSN; Sabine Wilhelm, PhD; Alan L. Peterson, PhD; Susanna Chang, PhD; Golda S. Ginsburg, PhD; Thilo Deckersbach, PhD; James Dziura, PhD; Sue Levi-Pearl, MA; John T. Walkup, MD
    JAMA. 2010;303(19):1929-1937. doi:10.1001/jama.2010.607.

    Context Tourette disorder is a chronic and typically impairing childhood-onset neurologic condition. Antipsychotic medications, the first-line treatments for moderate to severe tics, are often associated with adverse effects. Behavioral interventions, although promising, have not been evaluated in large-scale controlled trials.

    Objective To determine the efficacy of a comprehensive behavioral intervention for reducing tic severity in children and adolescents.

    Design, Setting, and Participants Randomized, observer-blind, controlled trial of 126 children recruited from December 2004 through May 2007 and aged 9 through 17 years, with impairing Tourette or chronic tic disorder as a primary diagnosis, randomly assigned to 8 sessions during 10 weeks of behavior therapy (n = 61) or a control treatment consisting of supportive therapy and education (n = 65). Responders received 3 monthly booster treatment sessions and were reassessed at 3 and 6 months following treatment.

    Intervention Comprehensive behavioral intervention.

    Main Outcome Measures Yale Global Tic Severity Scale (range 0-50, score >15 indicating clinically significant tics) and Clinical Global Impressions–Improvement Scale (range 1 [very much improved] to 8 [very much worse]).

    Results Behavioral intervention led to a significantly greater decrease on the Yale Global Tic Severity Scale (24.7 [95% confidence interval {CI}, 23.1-26.3] to 17.1 [95% CI, 15.1-19.1]) from baseline to end point compared with the control treatment (24.6 [95% CI, 23.2-26.0] to 21.1 [95% CI, 19.2-23.0]) (P < .001; difference between groups, 4.1; 95% CI, 2.0-6.2) (effect size = 0.68). Significantly more children receiving behavioral intervention compared with those in the control group were rated as being very much improved or much improved on the Clinical Global Impressions–Improvement scale (52.5% vs 18.5%, respectively; P < .001; number needed to treat = 3). Attrition was low (12/126, or 9.5%); tic worsening was reported by 4% of children (5/126). Treatment gains were durable, with 87% of available responders to behavior therapy exhibiting continued benefit 6 months following treatment.

    Conclusion A comprehensive behavioral intervention, compared with supportive therapy and education, resulted in greater improvement in symptom severity among children with Tourette and chronic tic disorder.

    copy of the entire JAMA article is attached for download / viewing / printing
    Attached Files
    TouretteLinks Forum