Initial treatment retention for habit reversal training in adults with Tourette syndrome

Felicity Pilcher 1, Stefano Seri 2, Andrea E. Cavanna 1,2,3

1 Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, United Kingdom; 2 School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, United Kingdom; 3 Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, London, United Kingdom

Objective

Tourette syndrome (TS) is a chronic neuropsychiatric disorder characterised by multiple motor and phonic tics. Habit Reversal Training (HRT) is increasingly recognised as an effective behavioural intervention in the treatment of tics, however little is known about the characteristics of adult patients who attend HRT sessions.

Methods

In this study, the demographic and clinical characteristics of 57 adult patients with TS consecutively referred to HRT intervention were retrospectively reviewed. Correlation and regression analyses were used to examine associations between patients’ characteristics and their HRT attendance.

Results

Twelve out of 57 patients were excluded from the analysis because of inappropriate referral and/or insufficient data. One in three of the remaining patients (15/45) failed to attend HRT following referral by the treating consultant. There were no significant differences in the demographic or clinical characteristics between patients who attended HRT and patients who did not. A trend towards statistical significance (p = 0.08) was found for decreased tic severity as predictor of poor attendance. 

Conclusions

Our findings suggest that initial treatment retention for HRT in TS can be suboptimal and reasons for poor attendance might be external to demographic or clinical factors. The statistical trend for decreased tic severity as predictor of poor attendance is of potential clinical relevance and needs replication. Further investigations on larger clinical samples will help to optimise care pathways and resource allocation strategies for patients with tics referred to behavioural interventions.

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