Abstract
Compulsive and tic disorders are chronic, neuropsychiatric illnesses. Whilst compulsive disorders frequently, though not necessarily, appear during childhood or youth, tic disorders always do. More rapid detection and treatment of compulsive disorders coincide with more favorable clinical outcome. Guidelines by the American Academy of Child and Adolescent Psychiatry (AACAP) recommend behavioral therapy as a first- line treatment for mild to moderate symptoms, and a combination of behavioral therapy along with medication for severe symptoms. The core element of behavioral therapy for compulsive disorders is exposure and response prevention (ERP). Drug treatment is indicated in the event of such severe symptoms that patients’ social integration is significantly impaired. Tic disorders occur commonly amongst children and generally improve over time, with regressing symptoms throughout adolescence. Other comorbid, psychiatric disorders often affect patients’ mental health at least as significantly and should be given priority treatment. Most patients’ tic disorders display a marked increase in severity between five and ten years of age and, irrespective of treatment, quickly regress from twelve to eighteen years of age. The indication for treatment depends upon psychosocial impairments perceived by patients and those around them. The effectiveness of behavioral therapy for tic disorders has been proven through randomized and controlled studies, and the European Clinical Guidelines recommend behavioral therapy as a first-line treatment for tic disorders. Pharmacotherapy is indicated for severe and chronic tic disorders that significantly compromise the quality of life of children and young people.
Brezinka, Veronika