Tag Archives: Tourette Syndrome

Tic Treatments

Ask Dr. Ticcy: Can Dental Appliances Cure TS?

January 7, 2013 – 10:35 am
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Dear Dr. Ticcy,

I saw an article on the internet that says that dentists can cure TS, but I also know that there is no cure for TS. Can you explain this?

Sincerely,
Really Confused

Dear Really Confused,

You are correct; there is no cure for TS. That said, there are several online articles (as well as some discussion on our own TSFC Online Forum) that talk about a new treatment for TS involving a dental appliance.

This dental appliance, developed by dentists Anthony Sims and Brendan Stacks, is called a “Neurocranial Vertical Distractor.” It aims to relieve the physical pressure on the nerves at the base of the brain. Drs. Sims and Stacks believe that when the cranial nerves that control the front of the face, the sides of the face, and lower digestive system get compressed together (squished), they “cross talk”—they transfer nerve impulses from one to another and in doing so, they bypass the higher control centre of the brain. These dentists say the Neurocranial Vertical Distractor, when inserted over the lower jaw, “distracts” the fibres entering the base of the brain preventing cross talk with neighbouring nerves.

To date there has only been one pilot study about this new treatment. It is called “Tourette’s Syndrome: A Pilot Study for the Discontinuance of a Movement Disorder” and is written by Drs. Sims and Stacks, creators of the Neurocranial Vertical Distracter. Published in the Journal of Craniomandibular Practice, the article contends that TS is not psychological, genetic or environmental in origin. Instead, Sims & Stack argue that it is a “structural reflex disorder”—a structural deformity that manifests itself as a neurological problem. How did they reach this conclusion? They reach it based on several cases in their pilot study where TS symptoms stopped after they inserted the device into their patients’ mouths.

In summary, while there is some anecdotal evidence that this treatment works for some individuals in some circumstances, there is no consensus among medical experts as to whether it works or does not work (at least none that the TSFC is aware of). There is only one scientific study on this treatment at present–so there is not a lot of information available.

If you are considering this treatment for yourself or a loved one, please be sure to consult with your treating physician.

If you want to learn more about treatments for TS, get the Canadian Guidelines for the Evidence-based Treatment of Tourette Syndrome, available as a book or a free downloadable PDF on the TSFC website.

Sincerely,
Dr. Ticcy

Dr. Ticcy is a pseudonym for the TSFC National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

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@Random TS Awareness

@RANDOM at Educator Gala Dinner

December 4, 2012 – 3:52 pm
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Recently, Douglas Coll, one of our National Directors, was invited to be the keynote speaker at the annual gala dinner for the Infundo Ephakemeyo Scholarship Fund. Doug was asked to speak on the importance of “education” as a tool to understanding and chose to speak on and present the @RANDOM documentary film project.

This amazing opportunity was provided to us through Paul Antunes, a long-time supporter and donor to the TSFC and his wife Rochina Antunes, a Vice-Principal at St. Maximilian Kolbe Catholic High School in Aurora, Ontario.

The 125 attendees, comprising a range of high school teachers, principals and board administrators from the York Catholic School Board, support this unique and worthwhile educational charity and are clearly an important constituency for the Tourette Syndrome Foundation of Canada.

The 25 minute presentation included an overview of the genesis of the idea, the development of the key creative direction, the project objectives and key partners, and finished with a showing of @RANDOM. This was an excellent opportunity to share @RANDOM as an “educational and awareness” tool for the TSFC and continue to build on our brand as a progressive, proactive organization.

Each year the Infundo Ephakemeyo Scholarship Fund offers several scholarships/awards to youth of Zimbabwean heritage towards post secondary education. These awards are determined on a competitive basis and require the submission of an essay, statement of need, transcript/credit counseling summary, offer and acceptance of admission by an institution.

All students of Zimbabwean descent are encouraged to apply.

Pictured in photo: Left – Paul Antunes: Treasurer Infundo Ephakemeyo; Middle – Douglas Coll: National Director, TSFC; Right – Melton Moyo: Founder Infundo Ephakemeyo.

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Ask Dr. Ticcy Resources Tic Treatments

Ask Dr. Ticcy: Beta Blockers for TS?

September 28, 2012 – 2:27 pm
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Dear Dr. Ticcy,

Is there any evidence for the use of beta blockers to treat tics?
Thanks!
Christina

 

Dear Christina,

Beta blockers are very effective for—and are the first-line treatment for—a movement disorder known as Essential Tremor, or ET. While ET and TS are both common neurological conditions, they have distinct characteristics and treatment also varies greatly.

ET typically affects older Canadians, while TS initially affects young Canadians in most cases, and the movements associated with tremors are vastly different from the premonitory tics that define Tourette Syndrome. So while beta blockers have been demonstrated to significantly improve symptoms of ET, no such evidence has emerged suggesting that they reduce tic frequency or severity. Instead, the newest Canadian Clinical Guidelines recommends a number of other medications, such as haloperidol, an antipsychotic, for children, and tetrabenazine for adults. It should be noted that the guidelines strongly recommend non-pharmacological treatments for TS, including Habit Reversal Therapy (HRT) and Exposure and Response Prevention (ERP).

The new guidelines will be made available to the public later this year through the TSFC.

Sincerely,
Dr. Ticcy

Dr. Ticcy is a pseudonym for the TSFC National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

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Children/Youth Resources

Conquering Back-To-School Anxiety — Part 2

August 30, 2012 – 10:47 am
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Causes

As always, in order to understand how to combat the problem, we first need to understand its causes. “Understanding the reasons that students avoid school is the first step in getting them to return,” writes school psychologist Mary Wimmer. In her 2008 article entitled “Why Kids Refuse to Go to School,” Wimmer stresses that school refusal or school avoidance can’t be attributed to a single cause, it results from a complex mix of factors including mental health problems, family issues and the school environment.

Mental health challenges, whether anxiety, depression, Oppositional Defiance Disorder (ODD), Obsessive Compulsive Disorder, Panic Disorder or some combination of these, account for 90% of the cases of school refusal. According to authors Packer & Pruitt (2010), anxiety, more specifically Separation Anxiety, Generalized Anxiety Disorder, and Social/Performance Anxiety, is the leading cause of school avoidance behaviour, affecting 22% of school refusers.

Children with Separation Anxiety are usually very young, tend to be preoccupied with the possibility of harm befalling loved ones, and are overly dependent on their parents or caregivers. Social or Performance Anxiety, which accounts for 3.5% of school avoidances cases, is slightly different. Rather than worrying about loved ones, this type of anxiety disorder manifests itself as intense fear of judgement from others. As a result, children with this condition typically experience extreme nervousness prior to test taking, making presentations and participating in sports. Generalized Anxiety Disorder (GAD), a diagnosis received by 10.5 % of children affected by school phobia, refers to excessive anxiety and worry about any number of different events and situations. Just like individuals with Performance Anxiety, students who struggle with GAD are usually very unsure of themselves. Unlike cases of performance anxiety, individuals with GAD are perfectionists about their schoolwork; they may also consider the world to be a threatening place. This type of anxiety is associated with secondary health problems including fatigue, restlessness, irritability, sleep problems and muscle tension.

In about 4.9% of case of school avoidance, depression is a primary casual factor. The presence of depression in school refusers is very serious as it is associated with very severe symptoms: self-mutilation, suicidal ideation, suicide attempts and uncontrolled worry.

In addition to mental health problems, scholars also point to school-based factors as drivers of school avoidance behaviour. Large class sizes, an authoritarian style of school management, a high level of discipline problems in school, large groups of low-achieving older students and school violence all can contribute to a student’s anxiety and worry about attending school.

These variables may be compounded by family factors as well. Unfortunately, identifying these factors in a specific case can be extremely difficult. “Parents of students who refuse to go to school for emotional reasons are a diverse group,” writes Wimmer. Some parents of school avoiders are healthy and high functioning, while others struggle with dependency, anxiety, depression, substance abuse, high levels of conflict, and/or emotional detachment. Specific events in the family can trigger school refusal behaviour including prolonged illness, a death of a parent, a vacation or even a weekend.

This is part two of a three-part daily series on back-to-school anxiety. Part three will be published on Friday.

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Children/Youth Resources

Conquering Back-To-School Anxiety — Part 1

August 29, 2012 – 10:39 am
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Fall is fast approaching, and in a few short days, it will be that time again—time to pick up the books, pack the school bag and head back to school!

For many school-aged children, it’s an exciting time—a chance to catch up with friends, swap stories about the summer, sport new outfits and show off new school supplies. It is important to remember, however, that not every child feels this way. For some kids, the prospect of returning to school is unsettling, even dreadful. Rather than feeling excitement, they feel intense fear and anxiety leading them to declare, “I hate school” or “I really, really don’t want to go to school.”

The layperson’s term for this phenomenon is “back-to-school anxiety.” Scholars of the subject call it school phobia, school avoidance or school refusal. Simply defined, these terms refer to any anxiety and fear associated with going to school that can result in a pattern of avoidance of, or refusal to attend, school. This is not to be confused with a dislike of or desire to avoid schoolwork. Quite the opposite; according to one scholar, “Those with true school refusal…are usually willing to complete school work as long as it’s done at home.”

School phobia/avoidance is no small problem. Studies suggest that it affects between 2-5% of all school-age children, with the highest incidence occurring among children between the ages of 5 and 6 (age 6 also happens to be the average age when someone with TS first starts experiencing symptoms).

Left unaddressed, school phobia can have serious consequences. In the short-term, it can lead to poor academic performance, parental conflict, and diminishing peer relationships. In the long-term, it can result in academic failure, school dropout and employment difficulties.

So, what can be done about it? Can it be curbed? Eliminated? Prevented? If so, how?

This is part one of a three-part daily series on back-to-school anxiety. Parts two and three will be published tomorrow and Friday, respectively.

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TS History TS Research

The Late, Great Dr. Arthur Shapiro

August 16, 2012 – 1:39 pm
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In 1965, a psychiatrist named Arthur Shapiro (pictured left) received a referral from a local neurologist. The referred patient was a young woman working as a secretary who was experiencing unwanted, repetitive behaviours including frequently sticking out her tongue and shouting obscenities in inappropriate contexts.

At the time, of the referral many in the medical community believed that repetitive tics were connected to sexual feelings and sexual expression. As a result, many also believed that Sigmund Freud’s psychoanalytic method was the best possible treatment for tics.

Dr. Arthur Shapiro, on the other hand, felt very differently. Recalling his interactions with this young woman, he told People Magazine: “I had the instinctive clinical feeling…that my patient’s condition was not psychological but organic.”  This feeling led Dr. Shapiro to do some research on his patient’s symptoms.

After extensive reading, Dr. Shapiro concluded that this young woman had Gilles de la Tourette Syndrome or TS. He then tried everything he could to help reduce her symptoms including psychotherapy, hypnosis and 36 different medications. Unfortunately, none of these treatments had any effect.

A breakthrough finally came in the form of an article. Shapiro read that a French physician successfully treated a patient with TS using a drug called haloperidol and decided to give this a try. On attempt number 37, after giving his patient haloperidol, the young woman’s symptoms began to show improvement!

In 1968, with the help of his psychologist wife Elaine (standing next to Arthur in the same photograph), Shapiro published an article about this experience. The article, “Treatment of Gilles de la Tourette’s Syndrome with Haloperidol,” documented how the neuroleptic drug haloperidol could help to manage TS symptoms. Most importantly, the article concluded that TS was not likely a purely a psychological problem.

Forty-four years later, his conclusion is still relevant. To this day, the medical community defines TS as a neurological or neuropsychiatric condition, rather than a purely psychological one.

The list of Dr. Shapiro’s contributions to the TS causes does not end there. Following his haloperidol study, Dr. Shapiro devoted himself to dispelling misconceptions about the condition and to establishing accurate diagnostic criteria. He wrote extensively on the subject and he and his wife helped to create the American Tourette Syndrome Association (TSA), an organization that continues to help individuals with TS and their families to this day.

At the time of his death, at age 72, Dr. Shapiro was still hard at work for the TS cause as the Director of the Tourette Research Foundation.

The TS community undoubtedly is grateful to this great doctor for all his contributions. They will not soon be forgotten!

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General Resources

Not Enough Data for Accurate Estimate of TS Incidence: Dr. Tamara Pringshiem

July 24, 2012 – 2:12 pm
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Dr. Tamara Pringsheim

Hot off the presses is “Prevalence of Tic Disorders: A Systematic Review and Meta-Analysis,” an article published in the journal Paediatric Neurology by several physicians, including Dr. Tamara Pringshiem. Dr. Pringshiem is a member of the Tourette Syndrome Foundation of Canada’s Professional Advisory Board. The TSFC community has the chance to hear Dr. Pringshem speak at the upcoming National Conference in October where she will present on the latest treatment guidelines for TS.

Dr. Pringshiem’s recent article focuses on the problem of under-diagnosis of TS and other tic disorders. The under-diagnosis of TS is a complex issue. Many people with TS are unaware that they have the condition. One study even puts the percentage of people who do not know they have TS at 30%. Tics can, and often are, suppressed or disguised in public. Additionally, they often decline with age. On top of that is the problem of people hiding the fact that they have TS due to fear of social stigma. All these factors combined make it extremely difficult to get an accurate estimate of the prevalence of the condition in the Canadian population.

Rather than relying on one or two studies to establish the current prevalence, Dr. Pringshiem and her colleges examined several different incidence studies in order to obtain the most accurate estimate possible.

Their main findings were:

  • Tic disorders, including TS, are more common among children than adults; and more common among males than females.
  • Tic disorders are more common in special education settings, among those receiving institutionalized care, and among those with Autism.
  • The most common type of tic disorder is transient tic disorder (approximately 2.99%), followed by chronic tic disorder.
  • TS is the third most common tic disorder.
  • There is no consensus among experts about the prevalence of TS and other tic disorders.
  • According to most school-based studies, 2-11 people out of every 1000 have TS.
  • The highest numbers, reported in three academic studies, put the incidence of TS at 3.8%. The lowest reported prevalence was 0.1%.
  • Very few studies focus on figuring out how many adults have TS.
  • Because the definition of TS has changed over time, prevalence hasn’t been consistently measured from study to study.
  • There is no current Canadian prevalence data; instead, incidence studies primarily focus on American and Western European populations.

Dr. Pringshiem and her colleagues recommend more studies on the prevalence of TS and other tic disorders. They also argue for the simplification of how we classify tic disorders. Making TS, chronic motor tic disorder, and chronic vocal tic disorder separate and distinct conditions, Pringshem et al. contend, is of “debatable value” because there are so few differences in the conditions and in how they are treated.

Perhaps as the TS community is more and more successful at eliminating stigma, more people will feel comfortable being “out” about their condition. As we as a country become more aware of the condition, those who do not know they have TS will come to understand why they do what they do. In time, perhaps, new studies may come to better understand the actual prevalence of condition in Canada. For now, we have to make do with only a few studies of the US and Europe and try to remember that the actual prevalence of TS is likely much higher than our best guess.

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Resources

Is Exercise Good for Your Mental Health?

July 17, 2012 – 3:38 pm
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If you have TS, you may also have another condition like as anxiety, depression, Attention Deficit/Hyperactivity Disorder, or Obsessive Compulsive Disorder. These conditions are treatable in most cases, through a regiment of either therapy and/or medication. But what about exercise?

We know that exercising regularly is good for our physical health; does it help with mental health as well? What does the research say? Read on to learn more.

Depression & Exercise

Depression is an extremely common condition, and not surprisingly, research strongly points to possible effects of exercise on depression. Several academic studies conclude that exercise is a good preventative strategy in that it helps reduce the risk of depression in both adolescents and adults. One Netherlands-based study based even found that it doesn’t take much to reap the mental benefits of physical fitness. The study found that for people with physically undemanding jobs, like an office job, all it takes to reduce the risk of depression and emotional exhaustion is strenuous exercise once or twice a week.

Exercise helps to prevent depression, but can it also be used to treat the condition? According to a recent analysis of several studies on this topic, there is not enough high quality research to support the claim that exercise reduces depression symptoms. However, there are some preliminary supportive findings, so it may very well be that exercise does help.

Does exercise also help with other mental health conditions?

According to PhDs Jerome Sarris, David Camfield and Michael Berk, the answer is possibly. In their 2011 article, “Complementary medicine, self-help and lifestyle interventions for OCD,” the authors say that there is some evidence that exercise can help reduce obsessions and compulsions, but not enough to make a firm conclusion.

Gapin et al. (2011) came to a similar conclusion in their study of exercise and ADHD. They found some evidence that exercise helps with behaviour and cognitive functioning in people with ADHD, but they were ultimately inconclusive.

Another interesting question is whether people with mental health challenges actually want to exercise. According to Mind, a UK charity, 83% of individuals with mental health problems use exercise to improve their mood and/or reduce stress and two-thirds of them say that exercise helps their condition.

The science

So how does this work exactly?

Well, exercise increases the flow of blood to the brain, causing the release of endorphins, a mood-enhancing chemical. Norepinephrine, dopamine, and serotonin—all mood-lifting chemicals that usually decrease during depression—also increase when we exercise.

Some studies suggest that there is a link between levels of brain-derived neurotrophic factor or BDNF, (another mood-enhancer) and exercise. There is also some recent evidence suggesting that exercise can increase brain plasticity meaning that it can improve cognitive functioning.

Psychologists add that exercise improves mood because it increases a person’s sense of physical self-worth, self-esteem and gives people a more positive body image.

How to Get Exercising Today

  • Getting fit isn’t as complicated or as costly as you may think. You can bike, run or walk outside—for free! To start with, try walking or biking to work or school
  • You will likely find reasonably priced fitness programs offered by your local YMCAs and community centres if you are willing to spend some money
  • Keep your eyes peeled for special deals! For example, Good Life Fitness is currently offering their facilities to teens for free this summer!: http://www.goodlifefitness.com/teenfitness/

To learn more about physical fitness, check out the Public Health Agency of Canada’s website and online fact sheets: http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/pa-ap/index-eng.php

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Resources Tic Treatments

Does BOTOX help with tics?

July 5, 2012 – 10:48 am
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Recently, several TSFC members asked National Office staff about the use of BOTOX injections as a tic treatment. In response, the TSFC did some research and here is what we found.

In the current clinical guidelines for treating Tourette Syndrome, BOTOX has a “weak recommendation” due to the low quality of medical evidence in favour of the treatment.  The authors state that:

While the consensus group believes that botulinum toxin injections are generally safe and without systemic side effects, we recommend using this treatment in only very specific situations. Botulinum toxin injections should be considered for the treatment of severely disabling vocal tics, such as coprolalia, or very distressing motor tics involving the upper face or neck. Further, only an experienced clinician should administer botulinum toxin injections.

What do studies about the treatment indicate?

In 2000, an article published in the Archives of Neurology called, “Botulinum Toxin in the Treatment of Tics,” evaluated the effectiveness and safety of BOTOX injections in the treatment of tics in patients with TS.

In their background research, the authors noted that Botulinum toxin (BTX) has been successfully used to treat conditions with abnormal and involuntary movements. They followed 35 patients with TS (30 male and 5 female) who ranged in age from 8-69 years old. These patients had 115 treatment sessions in total, with the majority receiving the injection in the upper face muscles, eyelids, and the ceverical muscles.

The results?

29 of the 35 patients experienced improvement in their tics;  84% of the patients also experienced improvement in their premonitory sensations. 5 patients experienced a tic-free period of greater than 1 year at the injection site, 3 of these five patients were injected only once. Side effects included: 1. some neck weakness lasting an average of 23 days (in 4 patients); 2. ptosis or drooping of the eyelid lasting 28 days (in 2 patients); 3. generalized weakness lasting 7 days (in 1 patient); 4. non-disabling dysphagia or swallowing difficulty lasting about 17 days (in 2 patients); 5. fatigue lasting for 14 days (in 1 patient) and 6. nausea and/or vomiting lasting 1 day (in 1 patient).

The authors concluded, “The findings of this study of 35 patients support the use of BTX injections as a safe and effective treatment for tics”.  However, the authors also noted that they were not sure if the patients who experience remission did so due to the treatment or coincidence. They also noted, “our study has several shortcomings and, therefore, the results must be interpreted cautiously.”

A subsequent 2004 study examined BOTOX treatment for phonic tics in TS patients. In this study, 30 patients received BOTOX injections in their vocal cords. 93% of patients found that their tics improved after the treatment, 50% were tic-free. Prior to the treatment 53% of the patients reported a premonitory sensation, after the treatment, this number decreased to 20%. The average response time to the treatment was 5.8 days with a range of 1-20 days. Patients noted an improvement for an average of 100 days with a range of 20-300 days. The only side effect experienced was hypophonia or weak voice due to lack of coordination of the vocal muscles. 24 subjects experienced this side effect for about 10 days. The authors concluded: “We consider that this treatment should be used more widely in the management of patients with phonic tics, particularly in patients who have poor compliance with drug regiments.”

The results of these two studies were replicated in a 2010 article published in Parkinsonism and Related Disorders. The authors concluded that “this study strongly suggests that treatment with BTX-A is effective in most patients with simple motor tics and retains its efficacy after long-term treatment.” The authors also point out that there were some limitations to their study due to their study design.

The study did find that were several side effects. For one patient, once her eye-blinking tic went away, she developed a sniffing tic which she found to be more socially challenging than the eye-blinking tic. Another patient experienced flu-like symptoms in the weeks following the injection, and felt that these symptoms grew stronger with each subsequent therapy. However, after ten treatments the flu-like symptoms resolved completely. Another patient experienced congestion for 2-4 weeks after injection in the ocular muscles. Muscle weakness and loss of facial expression were each noted once in different patients.

Another question often asked is whether BOTOX as a tic treatment is covered by public health insurance plans. According to the Canada Revenue Agency, “botulinum injections are only a [covered] medical expense if it is necessary for medical and reconstructive purposes such as surgery to address a deformity related to a congenital abnormality, a personal injury resulting from an accident or trauma or a disfiguring disease.” Some private health care plan might cover the treatment.

To learn more about this treatment, talk to your treating physician.

If you received this treatment and want to share your experience, please leave a comment below. If you would like to share your story anonymously, send it via email to tsfc@tourette.ca and we will post it to the site without any authoring name.

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OCD Resources

Is CBT* the Right Treatment for Your OCD?

June 28, 2012 – 10:50 am
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Obsessive Compulsive Disorder (OCD) is a chronic anxiety condition that is often found in people with Tourette Syndrome. It is so common in fact, that studies indicate that 60% of people with TS also have OCD. This makes OCD the most common co-occurring “+” in TS+ alongside ADHD.

OCD symptoms include obsessions, or recurrent thoughts or mental images; and compulsions, acts aimed at reducing anxiety (even if they are not logically connected with the anxiety or fear). Common obsessions include fear of germs, desire for cleanliness, and wanting everything to be “just right.” Common compulsions include repeated hand-washing, repetitive counting, lining up clothes by colour, and constantly checking that you locked the door. There are many other types of obsessions and compulsions, too many to list here.

OCD is a medical condition; it is not simply about being fixated on something. For example, checking once or twice that you locked the front door or turned off the curling iron does not mean you have OCD. OCD involves obsessions and compulsions that significantly impair day-to-day functioning. For example, if you can’t get to work on time because you need to wash your dishes over and over, or you can’t sleep until you wash the floor three times daily to the point that you are unable to get a full night’s rest, this may be OCD. If you think you have OCD, do not self-diagnose and/or self-treat, see your doctor and tell them why you think you may have this condition.

To date the most effective psychological treatment for OCD is Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention or (E/RP). E/RP involves confronting fears and learning to discontinue your natural escape response that usually follows the confrontation. Cognitive Behavioural Therapy involves learning to replace negative thinking and over-generalizing with positive, effective, and realistic thinking with the end goal being decreased emotional distress and decreased self-defeating behaviour.

Several studies find that the use of CBT, even in extremely severe OCD cases, can lead to clinically significant improvements in symptoms. However, some studies also find that many individuals still experience some symptoms rather than a “full recovery” or “remission” after doing CBT. Unfortunately, CBT and E/RP can be costly when they are not covered. They are also extremely time-consuming since they require many months of frequent therapy sessions in order to be successful.

It is for these reasons that two Australian doctors examined exactly what factors are associated with successful CBT treatment outcomes in OCD patients. They published their findings in 2011 in the Journal of Counselling and Psychotherapy.

What did they discover?

First of all, they concluded that: “predicting the CBT outcome in adult OCD is difficult.” Gender, how long a person had OCD, age of onset, and whether or not they had other co-occurring psychological conditions like anxiety or depression, was not related to treatment outcomes.

For the most part, treatment success was also unrelated to the type of obsession and/or compulsion, except for sexual obsessions, which they found to be associated with poorer treatment results.

Another factor they found to be associated with poorer treatment outcomes was severity of symptoms. Their study showed that if a person began CBT treatment with extremely severe symptoms, they were the more likely to conclude treatment with some severe symptoms.

A word of caution: the authors noted that their results are consistent with another study that found that more severe OCD is associated a poorer treatment outcomes. However, they pointed out that a different study found contradictory results.

Due to this contradiction they stated, “lack of consistency in the research…makes targeting specific treatments at those most likely to improve a difficult [task]”. As a result, they concluded, “CBT-based treatment for OCD should be recommended for all individuals with the condition.”

If you think you or a loved one may have OCD, talk to your family doctor about it. They can help refer you to a practitioner who can administer CBT. You should not receive CBT from someone who is not a licensed professional like a physician or psychologist.

If you would like a name and phone number for a licensed CBT professional in your area, call or email the National Office at 1-800-361-3120 or tsfc@tourette.ca.

Have you ever had CBT? What was it like? Did it help? Share your stories in the comments.

*CBT stands for Cognitive Behavioural Therapy. If you would like more information on CBIT, which stands for Cognitive Behavioural Intervention for Tics, please read about it here or call or email the National Office at tsfc@tourette.ca or call us at 905-673-2255 or toll free at 1-800-361-3120.

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