title: Habit reversal versus supportive psychotherapy in Tourette's disorder: a randomized controlled trial and predictors of treatment response.
abstract: Tourette syndrome (TS) is characterized by chronic motor and vocal tics. Habit reversal therapy (HR) is a behavioral treatment for tics which has received recent empirical support. The present study compared the efficacy of HRT in reducing tics, improving life-satisfaction and psychosocial functioning in comparison with supportive psychotherapy (SP) in outpatients with TS. In addition, we investigated whether impairments in response inhibition in patients with TS predict response to HR treatment which specifically aims to inhibit tics. Thirty adult outpatients with DSM-IV TS were randomized to 14 individual sessions of HR (n = 15); or SP (n = 15). HR but not SP reduced tic severity over the course of the treatment. Both groups improved in life-satisfaction and psychosocial functioning during active treatment. Reductions in tic severity (HR) and improvements in life-satisfaction and psychosocial functioning (HR and SP) remained stable at the 6-month follow-up. The extent of pre-treatment response inhibition impairment in the HR group predicted reductions in tic-severity from pre- to post-treatment. Our results suggest that HR has specific tic-reducing effects although SP is effective in improving life-satisfaction and psychosocial functioning. Assessments of response inhibition may be of value for predicting treatment response to HR.
authors.affiliation: OCD Clinic/Psychiatric Neuroscience Division, Department of Psychiatry, 149-2611, Massachusetts General Hospital, Charlestown, MA 02129, USA. tdeckersbach@partners.org
authors.forename: Thilo
authors.initials: T
authors.lastname: Deckersbach
authors.forename: Scott
authors.initials: S
authors.lastname: Rauch
authors.forename: Ulrike
authors.initials: U
authors.lastname: Buhlmann
authors.forename: Sabine
authors.initials: S
authors.lastname: Wilhelm
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D020323:Tics / Q000628:therapy; D005879:Tourette Syndrome / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome