Combined talk therapy for adults with obsessive-compulsive disorder and tics

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults with a Tourettic type of OCD, meaning they have both obsessive-compulsive symptoms and tics. It compares talking therapies for these symptoms.

Age

18 Years to 65 Years

Sex

All genders can join.

Disease stage

A main diagnosis of a tic disorder (such as Tourette syndrome, or a chronic, provisional or other tic disorder) or of obsessive-compulsive disorder (OCD). A score of at least 16 on the YBOCS and at least 5 on the Premonitory Urge for Tics Scale (PUTS) is needed.

Earlier treatment

People taking medicines for mental health can join if the type and dose stay the same during the therapy period.

Main reasons for not taking part

• Substance misuse
• Current personality disorder, schizophrenia or bipolar disorder
• Active thoughts of suicide
• Needing an interpreter
• Other mental health or nerve conditions that the study team thinks would affect taking part or the results

The registry criteria, word for word

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

• Are you between 18 and 65 years old?YesNo

What the trial wants to find out

Obsessive-Compulsive Disorder and Tic Disorders frequently co-occur, and a subgroup of patients - those with a Tourettic Subtype of OCD (TOCD) - present with concurrent obsessive-compulsive and tic symptoms. Existing psychological interventions typically target one condition or the other, but rarely both together. This study aims to test whether a combined psychological therapy integrating Exposure and Response Prevention (ERP) and Habit Reversal (HbRT) is more effective at reducing symptoms than either therapy delivered alone, in adults with TOCD.

The 4 groups in the trial

• Combined Exposure and Response Prevention and Habit ReversalTreatment being tested

  Participants allocated to this arm will receive a 12-week individual psychological intervention integrating Exposure and Response Prevention (ERP) and Habit Reversal Training (HRT). ERP will involve planned exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while reducing compulsions, avoidance, reassurance seeking, and other safety behaviours. HRT will include awareness training, identification of premonitory urges and tic-related cues, development and practice of competing responses, and strategies to support generalisation. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely.

  Treatment: Exposure and Response Prevention (ERP) and Habit Reversal Training (HbRT

• Standardised Exposure and Response PreventionExisting treatment, for comparison

  Participants allocated to this arm will receive a 12-week individual psychological intervention based on Exposure and Response Prevention (ERP). Treatment will involve gradual and systematic exposure to obsessional fears, distress, sensory discomfort, premonitory urges, and "not-just-right" experiences while refraining from compulsions, avoidance, reassurance seeking, and other safety behaviours. The intervention aims to reduce obsessive-compulsive symptoms by promoting inhibitory learning and increasing tolerance of uncertainty and internal experiences. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely.

  Treatment: Exposure and Response Prevention (ERP)

• Standardised Habit ReversalExisting treatment, for comparison

  Participants allocated to this arm will receive a 12-week individual psychological intervention based on Habit Reversal Training (HbRT). Treatment will include awareness training to improve recognition of tics and premonitory urges, identification of antecedents and contextual triggers, development and practice of competing responses, and strategies to promote generalisation of skills to everyday settings. The intervention aims to reduce tic severity and improve voluntary tic management. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely.

  Treatment: Habit Reversal Training (HbRT

• Psychoeducation / Supportive InterventionExisting treatment, for comparison

  Participants allocated to this arm will receive a 12-week individual psychological intervention consisting of psychoeducation and supportive therapy. Sessions will provide information about obsessive-compulsive disorder, tic disorders, Tourettic obsessive-compulsive disorder, stress, and wellbeing, together with supportive discussion and general problem-solving. This intervention will not include structured Exposure and Response Prevention, Habit Reversal Training, or other targeted behavioural techniques. Sessions will last approximately 50 minutes and will be delivered face-to-face or remotely.

  Treatment: Psychoeducation and Supportive Intervention