New type of behaviour therapy effective at reducing the tics of Tourette’s

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No one knows exactly what causes Tourette’s syndrome but it is believed to be a combination of genetic and environmental factors that trigger this distressing disorder.

Children and young people who suffer from the neurological disorder Tourette’s syndrome, often experience unpredictable and involuntary body movements which can include grimaces, twitches, head jerking and blinking as well as involuntary vocalisations such as grunting, sniffing, throat clearing, copying words of others or uttering obscenities. These are collectively known as tics.

Now researchers from the US may have found an effective non-drug treatment for children and young people suffering from the tic related disorders associated with Tourette’s.
Currently, the main treatment for tics is anti-psychotic medication which can reduce the severity and the frequency of the tics but which don’t actually cure them. As with any drug, but particularly anti-psychotic drugs, there are also the associated side effects to deal with which in some cases can be more distressing for the individual than the tics themselves.

The study was led by UCLA psychiatrist John Piacentini. Professor Piacentini and his colleagues used a new type of behaviour therapy called Comprehensive Behavioural Intervention for Tics, otherwise known as CBIT. CBIT involves the person with Tourette’s learning to recognise when a tic is about to start and then engaging in another completely voluntary but incompatible action until the feeling passes.

The researchers found that more than half of the children (53 percent) in the study that received CBIT significantly improved whereas only 19 percent of the children receiving another form of treatment saw an improvement.

“The fact that CBIT works about as well as the standard medications for tics but without the negative side effects greatly expands the available treatment options for chronic tic disorders,” said Susanna Chang, a UCLA assistant professor of psychiatry and a study author.

“Importantly, CBIT also emphasizes the development of skills that foster autonomy and empowerment, allowing for patients and their families to take a more active role in treatment than previously indicated.”

The Tourette Syndrome Association and the US Centers for Disease Control and Prevention are now working with investigators to teach Comprehensive Behavioural Intervention for Tics techniques to health professionals involved in treating people with tic disorders and to develop new versions of CBIT for use with younger children and by nurses and other health care professionals.

The study has now been published in the May 19th issue of the Journal of the American Medical Association.

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