Non-drug therapy for tic disorders in children / 中华实用儿科临床杂志

ABSTRACT

For tic disorders(TD),non -drug therapy including psychotherapy,behavioral intervention,neural regulation have demonstrated efficacy in reducing tic severity,managing co -occurring psychiatric symptoms and impro-ving life quality in addition to pharmacotherapy.Psychotherapy such as supportive psychotherapy,family intervention, school intervention can be major contributors to the development of evidence -based non -drug treatments.Different behavioural therapies that were used included positive reinforcement,extinction,massed negative practice,relaxation therapy,habit reversal training(HRT),exposure with response prevention,self -monitoring,contingency management, cognitive -behavioural therapy,assertiveness training,tension -reduction technique.Overall,HRT is the best -studied and most widely -used technique and there is sufficient experimental evidence to suggest that it is an effective treat-ment.Evidence suggests that exposure with response prevention and self -monitoring are effective,but comprehensive behavioral intervention for tics (CBIT)show more effective and durability of benefit over time.CBIT may promote nor-malization of aberrant cortico -striato -thalamo -cortical associative and motor pathways in individuals with tourette′s syndrome.Based on available evidence,recent published guidelines suggest that CBIT can be considered a first -line treatment for persons with TD.Neural regulation included electroencephalogram biofeedback,deep brain stimulation, transcranial magnetic stimulation are increasingly considered when tics become troublesome or even disabling or self -injurious despite optimal medical therapy.