TY - JOUR
T1 - Addressing co-occurring conditions in behavioural therapy for tic disorders
T2 - a review and guideline
AU - Sanderson, Charlotte
AU - Verdellen, Cara
AU - Debes, Nanette
AU - Tárnok, Zsanett
AU - van de Griendt, Jolande
AU - Zimmerman-Brenner, Sharon
AU - Murphy, Tara
N1 - © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
PY - 2024/7
Y1 - 2024/7
N2 - Co-occurring psychiatric conditions are very common in tic disorders and Tourette syndrome. These additional symptoms are often detrimental to quality of life and may impact upon the implementation and efficacy of evidence-based behavioural therapies (BT) for tics. Combining a review of the available literature, relevant theory, and expert clinical practice, we present a guideline for implementing behavioural and psychosocial interventions when common comorbidities are present. These include attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, disruptive behaviour, autism spectrum disorder (ASD) and depression. Practical recommendations are provided for assessment, formulation and management of specific and multiple comorbidities in BT for both children and adults. Despite comorbidities being common in tic disorders, few studies have comprehensively addressed how they may influence the efficacy or implementation of existing therapies or how such treatments may need to be modified or sequenced. We outline recommendations for future research, including randomised control trials of BT for those with specific or multiple comorbidities, as well as adequately powered sub-group analyses within larger scale trials or naturalistic study designs. Transdiagnostic models of psychiatric disorders and treatment, including modular cross-diagnostic therapies, which recognise the dimensionality of psychiatric disorders are also highlighted as an important focus in treatment development in tic disorders.
AB - Co-occurring psychiatric conditions are very common in tic disorders and Tourette syndrome. These additional symptoms are often detrimental to quality of life and may impact upon the implementation and efficacy of evidence-based behavioural therapies (BT) for tics. Combining a review of the available literature, relevant theory, and expert clinical practice, we present a guideline for implementing behavioural and psychosocial interventions when common comorbidities are present. These include attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, disruptive behaviour, autism spectrum disorder (ASD) and depression. Practical recommendations are provided for assessment, formulation and management of specific and multiple comorbidities in BT for both children and adults. Despite comorbidities being common in tic disorders, few studies have comprehensively addressed how they may influence the efficacy or implementation of existing therapies or how such treatments may need to be modified or sequenced. We outline recommendations for future research, including randomised control trials of BT for those with specific or multiple comorbidities, as well as adequately powered sub-group analyses within larger scale trials or naturalistic study designs. Transdiagnostic models of psychiatric disorders and treatment, including modular cross-diagnostic therapies, which recognise the dimensionality of psychiatric disorders are also highlighted as an important focus in treatment development in tic disorders.
KW - Adolescent
KW - Adult
KW - Attention Deficit Disorder with Hyperactivity/therapy
KW - Autism Spectrum Disorder/therapy
KW - Behavior Therapy/methods
KW - Child
KW - Comorbidity
KW - Humans
KW - Obsessive-Compulsive Disorder/therapy
KW - Practice Guidelines as Topic
KW - Tic Disorders/therapy
KW - Tourette Syndrome/therapy
UR - http://www.scopus.com/inward/record.url?scp=85141084894&partnerID=8YFLogxK
U2 - 10.1007/s00787-022-02097-1
DO - 10.1007/s00787-022-02097-1
M3 - Review
C2 - 36283996
SN - 1018-8827
VL - 33
SP - 2111
EP - 2127
JO - European Child & Adolescent Psychiatry
JF - European Child & Adolescent Psychiatry
IS - 7
ER -