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 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

PY - 2024

Y1 - 2024

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 - ADHD

KW - Anxiety

KW - ASD

KW - Autism

KW - Behavioural therapy

KW - Comorbidity

KW - Depression

KW - Disruptive behaviour

KW - Obsessive–compulsive disorder

KW - OCD

KW - Tic disorders

KW - Tourette syndrome

U2 - 10.1007/s00787-022-02097-1

DO - 10.1007/s00787-022-02097-1

M3 - Review

C2 - 36283996

AN - SCOPUS:85141084894

JO - European Child and Adolescent Psychiatry, Supplement

JF - European Child and Adolescent Psychiatry, Supplement

SN - 1433-5719

ER -