AUTHOR=Xu Wen , Ding Qiang , Zhao Ying , Jiang Wenqing , Han Jingjing , Sun Jinhua 

TITLE=A preliminary study of comprehensive behavioral intervention for tics in Chinese children with chronic tic disorder or Tourette syndrome

JOURNAL=Frontiers in Psychiatry

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.997174

DOI=10.3389/fpsyt.2022.997174

ISSN=1664-0640

ABSTRACT=<sec><title>Objective</title><p>To investigate the adaptability of Comprehensive Behavioral Intervention for Tics (CBIT) for a Chinese population, and evaluate the efficacy of combined CBIT and pharmacotherapy (CBIT + PT) compared to CBIT or pharmacotherapy (PT) alone for reducing tics and for improving the quality of life (QoL) in a sample of Chinese children with chronic tic disorders (CTD) and Tourette syndrome (TS).</p></sec><sec><title>Materials and methods</title><p>In this 10-week randomized controlled pilot trial, 37 outpatients aged between 6 and 16 years affected by TS and CTD were randomly assigned to receive CBIT (<italic>n</italic> = 22) or PT alone (<italic>n</italic> = 15). Considering the feasibility, the patients allocated to the CBIT treatment group could further choose whether to simultaneously take medicine voluntarily, resulting in a CBIT alone group (<italic>n</italic> = 12) and a CBIT + PT group (<italic>n</italic> = 10).</p></sec><sec><title>Results</title><p>At baseline, no significant difference was found between the three groups in the demographic and clinical characteristics (<italic>p</italic> &gt; 0.05). All three groups showed a significant reduction in tic severity after treatment assessed by the Yale Global Tic Severity Scale (YGTSS) severity score [<italic>F</italic><sub>(2</sub>,<sub>33)</sub> = 35.05, <italic>p</italic> &lt; 0.001, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.51], the score of the Clinical Global Impression scale for Improvement (CGI-I) [<italic>F</italic><sub>(1</sub>,<sub>34)</sub> = 13.87, <italic>p</italic> = 0.001, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.29], and YGTSS impairment score [<italic>F</italic><sub>(2</sub>,<sub>33)</sub> = 31.71, <italic>p</italic> &lt; 0.001, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.48]. Significant interactions were found between the time-point and group in emotional functioning [<italic>F</italic><sub>(2</sub>,<sub>29)</sub> = 4.39, <italic>p</italic> = 0.02, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.23], psychosocial functioning [<italic>F</italic><sub>(2</sub>,<sub>29)</sub> = 5.93, <italic>p</italic> = 0.007, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.29], and total QoL score [<italic>F</italic><sub>(1</sub>,<sub>34)</sub> = 3.72, <italic>p</italic> = 0.04, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.20] of Pediatric Quality of Life Inventory (PedsQL 4.0) for children suggesting a significantly larger improvement in emotional functioning, psychosocial functioning, and total QoL score of the life quality in the CBIT group for children self-report. PedsQL for proxy report only showed a significant main effect of time-point in physical functioning [<italic>F</italic><sub>(1</sub>,<sub>33)</sub> = 8.35, <italic>p</italic> = 0.01, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.2], emotional functioning [<italic>F</italic><sub>(1</sub>,<sub>33)</sub> = 10.75, <italic>p</italic> = 0.002, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.25], psychosocial functioning [<italic>F</italic><sub>(1</sub>,<sub>34)</sub> = 11.38, <italic>p</italic> = 0.002, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.26], and total Qol score [<italic>F</italic><sub>(1</sub>,<sub>34)</sub> = 13.21, <italic>p</italic> = 0.001, η<italic><sub><italic>p</italic></sub></italic><sup>2</sup> = 0.29].</p></sec><sec><title>Conclusion</title><p>CBIT is probably effective in reducing tic severity in Chinese children with tic disorders. CBIT + PT may not be superior to CBIT alone in reducing tic severity and improving quality of life. CBIT alone showed advantages in improving quality of life over CBIT + PT and PT alone. CBIT might be an appropriate treatment option for patients with tic disorder in Chinese mainland.</p></sec>