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《治疗抽动:基于群组的简短密集暴露治疗青少年抽动障碍:一项随机对照试验的结果》

Tackle your Tics, a brief intensive group-based exposure treatment for young people with tics: results of a randomised controlled trial.

机构信息

Academic Center for Child and Adolescent Psychiatry, Levvel, Amsterdam, The Netherlands.

Department of Child and Adolescent Psychiatry, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Eur Child Adolesc Psychiatry. 2024 Nov;33(11):3805-3818. doi: 10.1007/s00787-024-02410-0. Epub 2024 Apr 4.

Abstract

Tics can have a serious impact on the quality of life of children and their families. Behavioural therapy is an evidence-based first line treatment for tic disorders. This randomised controlled trial studied the efficacy of a brief, condensed group-based programme for children with tics (Dutch Trial Registry NL8052, 27 September 2019). Tackle your Tics is a four-day group treatment, including exposure and response prevention and supporting components, delivered by therapists and 'experts by experience'. We collected outcome measures at baseline (T1), directly post-treatment (T2), and at three- and 6-months follow-up (T3, T4) including tic severity (primary outcome measure), tic-related impairment, quality of life, tic-related cognitions, emotional/behavioural functioning, family functioning, treatment satisfaction and adherence. Outcomes directly post-treatment improved in both the treatment group (n = 52) and waiting list (n = 54), but showed no statistically significant differences between the conditions (differential change over time T1-T2) on tic severity (Yale Global Tic Severity Scale), quality of life (Gilles de la Tourette Syndrome Quality of Life Scale), tic-related cognitions and family functioning. At longer term (T3), again no between-group difference was found on tic severity, but tic-related impairment, quality of life and emotional/behavioural functioning significantly improved in the treatment group compared to the waiting list. Mean treatment satisfaction scores were favourable for both children and parents. Directly posttreatment, Tackle your Tics showed no superior effect compared to waiting list. However, on longer term this brief four-day group treatment was effective in improving tic-related impairment, quality of life and emotional/behavioural functioning.

摘要

抽动症会严重影响儿童及其家庭的生活质量。行为疗法是抽动障碍的一线循证治疗方法。这项随机对照试验研究了一种针对抽动儿童的简短、浓缩的基于小组的方案(荷兰试验注册处 NL8052,2019 年 9 月 27 日)的疗效。Tackle your Tics 是一种为期四天的小组治疗,包括暴露和反应预防以及支持性组成部分,由治疗师和“有经验的专家”提供。我们在基线(T1)、直接治疗后(T2)以及 3 个月和 6 个月随访(T3、T4)时收集了结果测量,包括抽动严重程度(主要结果测量)、与抽动相关的损伤、生活质量、与抽动相关的认知、情绪/行为功能、家庭功能、治疗满意度和依从性。治疗组(n=52)和等待名单组(n=54)在直接治疗后都有改善,但在条件之间没有显示出统计学上的显著差异(T1-T2 时的差异变化)在抽动严重程度(耶鲁综合抽动严重程度量表)、生活质量(图雷特氏综合征生活质量量表)、与抽动相关的认知和家庭功能方面。在较长时间(T3),治疗组的抽动严重程度、与抽动相关的损伤、生活质量和情绪/行为功能也没有发现组间差异,但与等待名单组相比,治疗组的抽动严重程度、与抽动相关的损伤、生活质量和情绪/行为功能显著改善。儿童和家长对治疗满意度的平均评分都很满意。直接治疗后,Tackle your Tics 与等待名单相比没有显示出更好的效果。然而,从长期来看,这种简短的四天小组治疗在改善与抽动相关的损伤、生活质量和情绪/行为功能方面是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cb4/11588865/f0188cfc8040/787_2024_2410_Fig1_HTML.jpg

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