A tic is a sudden movement or speech that is repeated over and over. These movements cannot be controlled and are hallmarks of certain neurological conditions; such as Tourette Syndrome. For many, minor tics will subside by early adulthood and do not interfere with quality of life. However, for some, the tics last into adulthood and interfere with daily tasks. Medication can help control the tics but can also cause side effects.
A team of United States researchers wanted to evaluate the effectiveness of a form of psychotherapy, called behavioral therapy, in managing tics. The randomized trial, published in Archives of General Psychiatry, found that behavioral therapy was a safe and effective way to manage tics in adult and children.
The randomized trial included 122 patients aged 16-69 years with Tourette syndrome or chronic tic disorder. The tics had to be at least moderately severe. The participants were divided into a treatment or control group. The treatment involved eight behavioral therapy sessions over 10 weeks while participants in the control group had eight sessions of supportive treatment during the same period. About 25% of participants were also using an anti-tic medication.
The severity of participants' tics was assessed just before and after treatment. By the end of the treatment period, researchers found:
- Reduced tic severity measured by the Yale Global Tic Severity Scale in 25.8% of participants in behavior therapy compared to 11.5% of participants in the control group
- Much or very much improved Clinical Global Impressions-Improvement Scale scores in 38.1% of participants in behavior therapy vs. 6.8% of participants in the control group
Some participants continued with a booster therapy session every three months. At six months, 63% of participants that continued therapy were available for reassessment. The benefits were found to continue in 80% of participants that had treatment compared to 50% of participants in the control sessions. There were no adverse events associated with behavior therapy.
Randomized trials are considered a very reliable research method. This form of trial allows the researchers to account for other factors that can influence the outcomes. It also allows researchers to understand the degree of benefit by comparing participants who received treatment to similar participants in the control group. Other factors in the way the trial was conducted and the way participants were assigned or chosen will also affect the reliability of the outcomes. In this case, the trial was well done, which means that behavioral therapy is likely to be an effective treatment for tics.
The intensity of tics can vary with your age and your condition. The treatment needed will depend on how much your tics interfere with daily functions. Behavioral therapy may be an effective method for you, without the adverse events associated with medications. Talk with your doctor if tics have become difficult to manage. It may be important for your doctor to know any changes in your condition and your doctor may be able to recommend the best treatment approach for you.
Wilhelm S, et al. Randomized trial of behavior therapy for adults with tourette syndrome.
Arch Gen Psychiatry. 2012 Aug 1;69(8):795-803.
Last reviewed September 2012 by Brian P. Randall, MD
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