Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette’s syndrome

BACKGROUND Cognitive-behavioral therapy(CBT)and habit reversal training(HRT)have shown application potential in addressing tic symptoms and comorbid psychiatric conditions.Despite their theoretical potential,empirical evidence on their combined efficacy remains limited.AIM To evaluate the efficacy of CBT combined with HRT on anxiety disorders in children with Tourette’s syndrome(TS).METHODS Clinical data of children with TS admitted to our hospital from January 2022 to June 2023 were collected,and the patients were grouped into the conventional therapy(control)group and the CBT combined with HRT group.Baseline charac-teristics,anxiety scores,tic severity scores,treatment adherence,and parental satisfaction were assessed.Statistical analysis was performed using t-tests,chi-square tests,and correlation analysis.RESULTS A total of 136 patients,including 65 patients in the control group and 71 patients in the CBT combined with HRT group,were included.The CBT combined with HRT group showed remarkable improvements compared with the control group.Post-intervention assessment revealed a decrease in anxiety scores from 63.52±1.81 to 40.53±1.64(t=2.022,P=0.045),and the Yale Global Tic Severity Scale total score decreased from 22.14±5.67 to 16.28±4.91(t=2.288,P=0.024).Treatment adherence was significantly higher in the CBT combined with HRT group(85.47±7.62%)compared with the control group(82.32±6.54%;t=2.596,P=0.010).Parental satisfaction scores were also higher in the CBT combined with HRT group(8.69±1.77)compared with the control group(7.87±1.92;t=2.592,P=0.011).CONCLUSION This study demonstrates that CBT combined with HRT significantly reduces anxiety symptoms and tic severity in children with TS,with higher treatment adherence and parental satisfaction.These findings support the potential application of this comprehensive therapeutic approach for TS treatment.

Review of habit reversal training for tic disorders

Tic disorders(TD)is a neurodevelopmental disorder that is often first recognized in children and adolescents and is characterized mainly by motor and phonic tics.Drug treatment of TD has been criticized because of serious side effects,and TD treatment emphasizes behavioral psychotherapy.This study reviewed the most common behavioral psychotherapy for TD:habit reversal training(HRT).We examined the contents,variation,curative effects,and premonitory urge control of HRT and other behavioral psychotherapies.The findings suggest that current understanding of HRT is insufficient and further studies are needed.First,studies of online guidance training are needed to implement technology that can help more patients.Second,the future integration of HRT and other technologies is important.Third,imaging techniques could be used to further explore the brain mechanisms underlying HRT.Research on HRT for TD in China is insufficient.We call on more Chinese researchers to study,investigate,and develop technology to promote the development of behavioral psychotherapy for TD in China.