{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:26:43Z","timestamp":1792099603035,"version":"4.4.0"},"reference-count":84,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,5,2]],"date-time":"2016-05-02T00:00:00Z","timestamp":1462147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["10\/142\/01"],"award-info":[{"award-number":["10\/142\/01"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004321","name":"Shire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2016,9]]},"abstract":"\n Background<\/jats:title>\n \n Tourette syndrome (\n TS<\/jats:styled-content>\n ) and chronic tic disorder (\n CTD<\/jats:styled-content>\n ) affect 1\u20132% of children and young people, but the most effective treatment is unclear. To establish the current evidence base, we conducted a systematic review of interventions for children and young people.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Databases were searched from inception to 1 October 2014 for placebo\u2010controlled trials of pharmacological, behavioural, physical or alternative interventions for tics in children and young people with\n TS<\/jats:styled-content>\n or\n CTD<\/jats:styled-content>\n . Certainty in the evidence was assessed with the\n GRADE<\/jats:styled-content>\n approach.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty trials were included [pharmacological (32), behavioural (5), physical (2), dietary (1)]. For tics\/global score there was evidence favouring the intervention from four trials of\n \u03b1<\/jats:italic>\n 2\u2010adrenergic receptor agonists [clonidine and guanfacine, standardised mean difference (\n SMD<\/jats:styled-content>\n )\u00a0=\u00a0\u22120.71; 95%\n CI<\/jats:styled-content>\n \u22121.03, \u22120.40;\n N\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 164] and two trials of habit reversal training (\n HRT<\/jats:styled-content>\n )\/comprehensive behavioural intervention (\n CBIT<\/jats:styled-content>\n ) (\n SMD<\/jats:styled-content>\n \u00a0=\u00a0\u22120.64; 95%\n CI<\/jats:styled-content>\n \u22120.99, \u22120.29;\n N\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 133). Certainty in the effect estimates was moderate. A post hoc analysis combining oral clonidine\/guanfacine trials with a clonidine patch trial continued to demonstrate benefit (\n SMD<\/jats:styled-content>\n \u00a0=\u00a0\u22120.54; 95%\n CI<\/jats:styled-content>\n \u22120.92, \u22120.16), but statistical heterogeneity was high. Evidence from four trials suggested that antipsychotic drugs improved tic scores (\n SMD<\/jats:styled-content>\n \u00a0=\u00a0\u22120.74; 95%\n CI<\/jats:styled-content>\n \u22121.08, \u22120.40;\n N\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 76), but certainty in the effect estimate was low. The evidence for other interventions was categorised as low or very low quality, or showed no conclusive benefit.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n When medication is considered appropriate for the treatment of tics, the balance of clinical benefits to harm favours\n \u03b1<\/jats:italic>\n 2\u2010adrenergic receptor agonists (clonidine and guanfacine) as first\u2010line agents. Antipsychotics are likely to be useful but carry the risk of harm and so should be reserved for when\n \u03b1<\/jats:italic>\n 2\u2010adrenergic receptor agonists are either ineffective or poorly tolerated. There is evidence that\n HRT<\/jats:styled-content>\n \/\n CBIT<\/jats:styled-content>\n is effective, but there is no evidence for\n HRT<\/jats:styled-content>\n \/\n CBIT<\/jats:styled-content>\n alone relative to combining medication and\n HRT<\/jats:styled-content>\n \/\n CBIT<\/jats:styled-content>\n . There is currently no evidence to suggest that the physical and dietary interventions reviewed are sufficiently effective and safe to be considered as treatments.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jcpp.12556","type":"journal-article","created":{"date-parts":[[2016,5,2]],"date-time":"2016-05-02T02:07:55Z","timestamp":1462154875000},"page":"988-1004","source":"Crossref","is-referenced-by-count":103,"title":["Practitioner Review: Treatments for Tourette syndrome in children and young people \u2013 a systematic review"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1950-0334","authenticated-orcid":false,"given":"Craig","family":"Whittington","sequence":"first","affiliation":[{"name":"National Collaborating Centre for Mental Health University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Pennant","sequence":"additional","affiliation":[{"name":"National Collaborating Centre\u00a0for 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