Behavioral therapy produces sustained improvements in tic symptoms for children and adolescents with Tourette syndromeBehavioral therapy eases tics in children with Tourette syndrome

BACKGROUND: Behavioural therapy (BT) alleviates tic symptoms in patients with Tourette syndrome/chronic tic disorder (TS/CTD). TS/CTD is often associated with emotional dysregulation, anxiety, and depressive symptoms, substantially impairing quality of life. Nevertheless, the specific effects of BT on tic symptoms in children and adolescents with TS/CTD, including persistence and follow-up outcomes, remain unclear. Tic symptoms in children with TS/CTD are often assessed using the Yale Global Tic Severity Scale (YGTSS) and the Parent Tic Questionnaire (PTQ)-when combined, these tools mitigate subjective biases and enhance assessment objectivity. This meta-analysis aimed to systematically review randomised controlled trials evaluating the impact of BT on tic symptoms in children and adolescents with TS/CTD and to examine longitudinal outcomes. METHODS: We systematically searched multiple databases for articles published up to May 2025 and screened their reference lists. The standardised mean difference (SMD) served as the primary effect size metric, focusing on YGTSS and PTQ indicators, from baseline to endpoint through follow-up. Subgroups, heterogeneity, risk of bias, and publication bias were analyzed. RESULTS: The meta-analysis included 11 studies, encompassing 21 datasets and involving 942 participants. Forest plot analysis revealed that BT improved tic symptoms in patients with TS/CTD compared with controls, as confirmed by both the YGTSS and PTQ assessments. The improvements persisted through follow-up. CONCLUSIONS: BT effectively produces sustained improvements in tic symptoms in children and adolescents with TS/CTD. The demonstrated reduction in core tic severity underscores the potential for BT to alleviate secondary emotional burdens and improve overall mental health in this population.