European clinical guidelines for Tourette Syndrome and other tic disorders. Part III: behavioural and psychosocial interventions

An Erratum to this article is available

Abstract

This clinical guideline provides recommendations for the behavioural and psychosocial interventions (BPI) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted to obtain an update on the efficacy of BPI for tics. Relevant studies were identified using computerised searches of the Medline and PsycINFO databases and the Cochrane Library for the years 1950–2010. The search identified no meta-analyses, yet twelve (systematic) reviews and eight randomised controlled trials provided evidence for the current review. Most evidence was found for habit reversal training (HRT) and the available but smaller evidence also supports the efficacy of exposure with response prevention (ERP). Both interventions are considered first line behavioural treatments for tics for both children and adults and should be offered to a patient, taking into account his preference. Treatments that are considered second line or add-on behavioural treatments are contingency management, function based interventions and relaxation training. Neurofeedback is still experimental. Almost no research was identified that examined the efficacy of psychosocial interventions, e.g., psychoeducation and group work. Based on clinical practice, this guideline recommends behavioural treatment as first line offer to patients in most cases. It should be embedded within a psychoeducational and supportive context and can be combined with drug treatment.

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Conflict of interest

Commercial firms and governmental organisations did not play a role in, or fund, the development of these guidelines. Cara Verdellen, Jolande van de Griendt, Andreas Hartmann, Tara Murphy declare that they have no conflict of interest.

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Correspondence to Cara Verdellen.

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Members of the ESSTS Guidelines Group are listed under Appendix.

An erratum to this article can be found at http://dx.doi.org/10.1007/s00787-011-0195-z

Appendix: Members of the ESSTS Guidelines Group

Appendix: Members of the ESSTS Guidelines Group

Christos Androutsos, Harald Aschauer, Gillian Baird, Netty Bos-Veneman, Ariana Brambilla, Francesco Cardona, Danielle C. Cath, Andrea E. Cavanna, Virginie Czernecki, Sandra Dehning, Alan Eapter, Luca Farkas, Julia Gadaros, Andreas Hartmann, Elizabeth Hauser, Isabel Heyman, Tammy Hedderly, Pieter J. Hoekstra, Anne Korsgaard, Georgina M. Jackson, Linnea Larsson, Andrea G. Ludolph, Davide Martino, Claudia Menghetti, Nanette Mol Debes, Norbert Muller, Kirsten Muller-Vahl, Alexander Munchau, Tara Murphy, Richard Musil, Peter Nagy, Judith Nurnberger, Ben Oostra, Perry Paschou, Massimo Pasquini, Kirsten J. Plessen, Mauro Porta, Hugh Rickards, Renata Rizzo, Mary M. Robertson, Veit Roessner, Aribert Rothenberger, Domenico Servello, Liselotte Skov, Jeremy S. Stern, Gerd Strand, Zsannett Tarnok, Cristiano Termine, Jolande Van der Griendt, Cara Verdellen, Veerle Visser-Vandewalle, Ebba Wannag, Tomas Wolanczyck

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Verdellen, C., van de Griendt, J., Hartmann, A. et al. European clinical guidelines for Tourette Syndrome and other tic disorders. Part III: behavioural and psychosocial interventions. Eur Child Adolesc Psychiatry 20, 197–207 (2011). https://doi.org/10.1007/s00787-011-0167-3

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Keywords

  • Tourette
  • Tic disorders
  • Guidelines
  • Behavioural treatment
  • Psychosocial interventions
  • Literature review