Chronic tic disorders, such as Tourette Syndrome, are characterized by motor and vocal tics. Tics present a considerable burden for some patients, and therefore effective treatment is important. One evidence-based treatment option is a behavioral therapy called Exposure and Response Prevention (ERP). Despite its effectiveness, access to ERP remains limited due to a lack of treatment sites. Web-based videoconferences can connect patients at home with a therapist located in the hospital, allowing for treatment delivery over a wide geographic area. The primary aim of this study was to compare the development of tics during and one year after ERP delivered respectively via web-based videoconferences and traditional face-to-face methods in a naturalistic setting. 116 patients treated using either the face-to-face method (n = 72) or web-based videoconferences (n = 44) were included. The primary outcome measure was tic severity. In both training modalities, tic severity decreased during ERP and the effect lasted in the follow-up period. No statistically significant differences in tic severity between the training modalities were found at baseline, last training session or at follow-up. Our results suggest that ERP delivered via web-based videoconferences is a good alternative to the traditional face-to-face method.
Tourette Syndrome and Chronic tic disorders are characterized by the presence of tics. Different behavioral therapies have shown to be efficacious for treating tics in children and adolescents, but Exposure and Response Prevention (ERP) is a less researched method. However, ERP is a method often used in the clinical setting. Therefore, the present study evaluated the severity of tics over time from beginning of ERP to follow-up approximately one year after last training session. 116 patients treated with ERP face-to-face or ERP via web-based videoconferencing were included. Primary outcome measure was tic severity measured with the Danish version of the Yale Global Tic Severity Scale. The results showed that tic severity decreased during ERP and lasted in the follow-up period, with a statistically higher decrease in the group with patients who completed ERP as planned and the group that stopped earlier than planned because of reduction in tics, compared to those who dropped out due to lack of motivation (p<0.001). The study concludes that ERP seems to have an immediate and a long-term effect on severity of tics, especially in those who complete the programme or those who discontinue earlier due to good results.
Aim The aim of this study was to evaluate if a combination of World Health Organization-5 (WHO-5), Anxiety Symptom Scale-2 (ASS-2) and Major Depression Inventory-2 (MDI-2) can replace the Hospital Anxiety and Depression Scale (HADS) as screening tool for anxiety and depression in cardiac patients across diagnoses, and whether it is feasible to generate crosswalks (translation tables) for use in clinical practice. Methods We used data from the Danish ‘Life with a heart disease’ survey, in which 10,000 patients with a hospital contact and discharge diagnosis of ischemic heart disease (IHD), heart failure (HF), heart valve disease (HVD) or atrial fibrillation (AF) in 2018 were invited. Potential participants received an electronic questionnaire including 51 questions on health, well-being, and evaluation of the health care system. Crosswalks between WHO-5/ASS-2 and HADS-A, and between WHO-5/MDI-2 and HADS-D were generated and tested using item response theory (IRT). Results A total of 4346 patients responded to HADS, WHO-5, ASS-2, and MDI-2. Model fit of the bi-factor IRT models illustrated appropriateness of a bi-factor structure and thus of essential uni-dimensionality (RMSEA(p value) range 0.000-0.053(0.0099-0.7529) for anxiety, and 0.033-0.061(0.0168-0.2233) for depression). A combination of WHO-5 and ASS-2 measured the same trait as HADS-A, and a combination of WHO-5 and MDI-2 measured the same trait as HADS-D. Consequently, crosswalks (translation tables) were generated. Conclusions Our study shows that it is feasible to use crosswalks between HADS-A and WHO-5/ASS-2, and HADS-D and WHO-5/MDI-2 for screening cardiac patients across diagnoses for anxiety and depression in clinical practice.
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