The Efficacy of Cognitive Behavioral Therapy for Tic Disorder: A Meta-Analysis and a Literature Review

Songting Shou; Yuanliang Li; Guohui Fan; Qiang Zhang; Yurou Yan; Tiying Lv; Junhong Wang

doi:10.3389/fpsyg.2022.851250

The Efficacy of Cognitive Behavioral Therapy for Tic Disorder: A Meta-Analysis and a Literature Review

Front Psychol. 2022 Mar 24:13:851250. doi: 10.3389/fpsyg.2022.851250. eCollection 2022.

Authors

Songting Shou¹, Yuanliang Li^{2

3}, Guohui Fan⁴, Qiang Zhang¹, Yurou Yan¹, Tiying Lv¹, Junhong Wang¹

Affiliations

¹ Department of Pediatrics, Dongzhimen Hospital, Beijing, China.
² Graduate School, Beijing University of Chinese Medicine, Beijing, China.
³ Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China.
⁴ Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China.

Abstract

Background: At present, tic disorder has attracted the attention of medical researchers in many countries. More clinicians choose non-drug therapy, especially cognitive-behavioral therapy (CBT) because of the cognitive side effects of drug therapy. However, few studies had assessed its efficacy. It is necessary to have a more comprehensive understanding of the literature quality of CBT and its intervention effect.

Methods: In this study, MEDLINE, Embase, and Cochrane were searched from the beginning to June 15, 2021 to study the efficacy of -CBT on tic disorder. Only studies using the Yale Global Tic Severity Scale (YGTSS) and the control group were included.

Results: A total of 12 randomized controlled trials (RCTs), including 536 patients with tic disorders, were identified. The results showed that the effect of CBT was better than that of the control group. The pooled standardized mean difference (SMD) was -0.34 (95% CI: -0.61, -0.07). The effect size of CBT differs from different intervention conditions. In seven studies, the subjects' motor tic scores were counted. The sample size of the experimental group was 224 and that of the control group was 218. The pooled SMD was -0.43 (95% CI: -0.75, -0.11). Seven studies counted the vocal tic scores of subjects, 224 in the experimental group and 218 in the control group. The pooled SMD was -0.22 (95% CI: -0.54, -0.11). Seven studies counted the tic impairment scores of subjects, 220 in the experimental group and 214 in the control group. The pooled SMD was -0.48 (95% CI: -0.73, -0.23).

Conclusion: The literature shows that different CBTs can significantly reduce the total score of tic disorder and the score of motor tic, but cannot significantly reduce the score of vocal tic. In the future, more new interventions were needed to improve the symptoms of different patients, especially vocal tic.

Keywords: cognitive behavioral therapy; comprehensive behavioral intervention for tics; habit reversal therapy; meta-analysis; tic disorders.

Publication types

Systematic Review