Acute and Long-Term Effects of an Internet-Based, Self-Help Comprehensive Behavioral Intervention for Children and Teens with Tic Disorders with Comorbid Attention Deficit Hyperactivity Disorder, or Obsessive Compulsive Disorder: A Reanalysis of Data from a Randomized Controlled Trial.

Lilach Rachamim,Michael Rotstein,Hila Mualem-Taylor,Sharon Zimmerman-Brenner,Osnat Rachamim

doi:10.3390/jcm11010045

Abstract

Attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and tic disorders (TD) commonly co-occur. In addition, specific inattention difficulties and poor impulse control are related to TD in the absence of comorbid ADHD. In this study we reanalyzed data from a recently completed study comparing internet-delivered, self-help comprehensive behavioral intervention for tics (ICBIT) with a waiting-list control group. The current study describes the effects of an (ICBIT) in children and adolescents with TD with and without comorbid diagnoses of ADHD or OCD at post intervention and over three- and six-month follow-up periods. Thirty-eight 7 to 18-year-olds completed the ICBIT. Of these, 16 were diagnosed with comorbid ADHD and 11 were diagnosed with OCD. A significant improvement in tic measures was found in all groups. Both the TD + ADHD and the TD − ADHD groups were similar in the magnitude of tic reduction from baseline to post-treatment, and at the three and six-month follow-up assessments. However, the TD + OCD group benefitted less from intervention than the TD—OCD group. There were meaningful reductions in parental reports of inattention, as well as hyperactive and impulsive symptoms at post intervention and over the 6-month follow-up period. Thus, ICBIT can be effectively delivered in the presence of comorbid ADHD or OCD symptomatology and may reduce symptoms of inattention and impulsivity. Larger studies of ICBIT in children and teens with TD and comorbid ADHD and OCD are needed to optimize responses to ICBIT.

Highlights

Tourette syndrome (TS) and chronic tic disorder (CTD) are neurodevelopmental disorders characterized by sudden, rapid, recurrent motor movements or vocalizations that persist for more than a year [1]
The CGAS scores in the tic disorders (TD) + Attention deficit hyperactivity disorder (ADHD) group were significantly lower, suggesting that ADHD leads to greater disability than TD alone
− obsessive compulsive disorder (OCD), TD + OCD − ADHD, TD − ADHD − OCD. In this post hoc reanalysis of our previous randomized controlled trials (RCTs) [25], we aimed to explore the effects of ICBIT on children and teens with TD with and without ADHD or OCD and assessed changes in ADHD and OCD symptomatology symptomatology over over aa 33- and and 6-month

Summary

Introduction

Tourette syndrome (TS) and chronic tic disorder (CTD) (collectively referred to as tic disorders TD) are neurodevelopmental disorders characterized by sudden, rapid, recurrent motor movements or vocalizations that persist for more than a year [1]. TS is defined by the presence of multiple motor and phonic tics. Children who exhibit motor or phonic tics, but not both, for at least a year are diagnosed as having CTD [1]. Tic symptoms remit for some children and teens, a considerable portion of adolescents have tics that persist into adulthood [2]. The population prevalence of CTD in children and teens is 1.5% to 3%. TS is estimated to occur in 0.3% to 0.9% of this population as a whole. TD can lead to behavioral and psychosocial impairments, loneliness, as well as shame and embarrassment [3,4]

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