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解决抽动问题:一项针对抽动障碍儿童的简短、密集的基于团体的暴露疗法方案的初步研究结果。

Tackle your Tics: pilot findings of a brief, intensive group-based exposure therapy program for children with tic disorders.

机构信息

Dutch Tourette Association, Alkmaar, The Netherlands.

Dutch Knowledge Centre for Child and Adolescent Psychiatry, Utrecht, The Netherlands.

出版信息

Eur Child Adolesc Psychiatry. 2021 Mar;30(3):461-473. doi: 10.1007/s00787-020-01532-5. Epub 2020 May 20.

Abstract

Tourette syndrome (TS) and other chronic tic disorders (CTD) are prevalent neurodevelopmental disorders, which can have a huge burden on families and society. Behavioral treatment is a first-line intervention for tic disorders. Despite demonstrated efficacy, tic reduction and utilization rates of behavioral treatment remain relatively low. Patient associations point to an urgent need for easy-to-undergo treatments that focus both on tic reduction and improvement of quality of life. To enhance treatment outcome and overcome treatment barriers, this pilot study's aim was to investigate the feasibility and preliminary results of a brief, intensive group-based treatment. Tackle your Tics is a 4-day intensive and comprehensive group-based program for children and adolescents (9-17 years) with a tic disorder, consisting of exposure and response prevention (ERP) treatment and additional supporting components, such as coping strategies, relaxing activities and parent support. Assessments were performed pre- and post-treatment and at 2 months follow-up, to test outcomes on tic severity and quality of life, and explore premonitory urges, emotional and behavioral functioning and treatment satisfaction (N = 14, of whom 13 completed the treatment). Parents and children rated this treatment positive on a treatment satisfaction questionnaire. On tic severity (Yale Global Tic Severity Scale) and quality of life (Gilles de la Tourette Syndrome Quality of Life Scale for children and adolescents), improvements between pre-treatment and follow-up were found. Intensive ERP in group format is promising as a feasible treatment to improve both tic severity as well as quality of life. Larger controlled trials are needed to establish its effectiveness.

摘要

妥瑞氏症候群(TS)和其他慢性抽动障碍(CTD)是常见的神经发育障碍,会给家庭和社会带来巨大负担。行为治疗是抽动障碍的一线干预措施。尽管已证明其疗效,但抽动减少和行为治疗的利用率仍然相对较低。患者协会指出,迫切需要易于接受的治疗方法,既要减少抽动,又要提高生活质量。为了提高治疗效果并克服治疗障碍,这项试点研究旨在探讨一种简短、密集的基于小组的治疗的可行性和初步结果。Tackle your Tics 是一种为期 4 天的密集综合小组治疗计划,适用于患有抽动障碍的儿童和青少年(9-17 岁),包括暴露和反应预防(ERP)治疗以及其他支持性组成部分,如应对策略、放松活动和家长支持。在治疗前、治疗后和 2 个月随访时进行评估,以测试抽动严重程度和生活质量的结果,并探讨前驱冲动、情绪和行为功能以及治疗满意度(N=14,其中 13 人完成了治疗)。家长和孩子在治疗满意度问卷上对这种治疗给予了积极评价。在抽动严重程度(耶鲁总体抽动严重程度量表)和生活质量(儿童和青少年 Gilles de la Tourette 综合征生活质量量表)方面,治疗前和随访时均有改善。小组形式的密集 ERP 具有作为一种可行的治疗方法的潜力,可以改善抽动严重程度和生活质量。需要更大规模的对照试验来确定其疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f394/8019419/1a25eafaf045/787_2020_1532_Fig1_HTML.jpg

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