Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis

IntroductionRecently, several studies about therapist-supported online remote behavioral therapy (TSORBT) have been showed effective for tic disorders (TD). With the increasing adoption of telemedicine, a systematic review of existing evidence is crucial to confirm the efficacy of TSORBT in treating...

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Main Authors: Xiaolei Xu, Kangsheng Zhu, Weiyi Wang, Tianyu Zhao, Congrui Fu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1521947/full
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author Xiaolei Xu
Kangsheng Zhu
Weiyi Wang
Tianyu Zhao
Congrui Fu
author_facet Xiaolei Xu
Kangsheng Zhu
Weiyi Wang
Tianyu Zhao
Congrui Fu
author_sort Xiaolei Xu
collection DOAJ
description IntroductionRecently, several studies about therapist-supported online remote behavioral therapy (TSORBT) have been showed effective for tic disorders (TD). With the increasing adoption of telemedicine, a systematic review of existing evidence is crucial to confirm the efficacy of TSORBT in treating TD.AimWe aim to assess the efficacy of TSORBT on the treatment of TD.MethodThis review followed PRISMA guidelines. We searched PubMed, Web of Science, Cochrane, and Embase up to September 2024 for clinical trials on TSORBT’s efficacy in TD. Two researchers independently screened studies, focusing on the Total Tic Severity Score of the Yale Global Tic Severity Scale (YGTSS-TTSS) and other subscores of the YGTSS-motor tic score (YGTSS-MTS), YGTSS-vocal tic score (YGTSS -VTS), YGTSS-impairment score and Parent Tic Questionnaire (PTQ). Risk of bias was assessed using Cochrane RoB 2. Data were analyzed in RevMan 5.4, with outcomes expressed as mean difference (MD) and 95% CI.ResultsIn total, 2764 articles were identified for screening. Nine studies involving 1049 participants, with 527 assigned to the TSORBT and 522 to the control were included. TSORBT exhibited potential in addressing YGTSS-TTSS (MD = -2.22, 95% CI: [-3.16, -1.29], P<0.00001), YGTSS-MTS (MD = -2.17, 95% CI: [-3.39, -0.96], P=0.0004), YGTSS-impairment score (MD= -1.69, 95% CI: [-3.26, -0.12], P=0.03) and PTQ score (MD= -6.05, 95% CI: [-8.65, -3.44], P<0.00001);. Subgroup analyses revealed that TSORBT demonstrated nearly the same efficacy as face-to-face BT in addressing YGTSS-TTSS (MD = -0.38, 95% CI: [-3.20, 2.43], P=0.79), but more effective than online psychoeducation (MD = -2.37, 95% CI: [-3.64, -1.10], P = 0.0002).ConclusionThe current study demonstrates the promising therapeutic efficacy of TSORBT in TD. Further rigorously designed studies, particularly those assessing long-term treatment durability, are warranted to consolidate the evidence base.
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spelling doaj-art-6148f62db3d14a388bfbc51245d326f82025-08-20T03:25:42ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-06-011610.3389/fpsyt.2025.15219471521947Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysisXiaolei Xu0Kangsheng Zhu1Weiyi Wang2Tianyu Zhao3Congrui Fu4School of Nursing, Hebei Medical University, Hebei, Shijiazhuang, ChinaDepartment of Anesthesiology, The Forth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Immunology and Pathobiology, Hebei University of Chinese Medicine, Shijiazhuang, ChinaSchool of Nursing, Hebei Medical University, Hebei, Shijiazhuang, ChinaSchool of Nursing, Hebei Medical University, Hebei, Shijiazhuang, ChinaIntroductionRecently, several studies about therapist-supported online remote behavioral therapy (TSORBT) have been showed effective for tic disorders (TD). With the increasing adoption of telemedicine, a systematic review of existing evidence is crucial to confirm the efficacy of TSORBT in treating TD.AimWe aim to assess the efficacy of TSORBT on the treatment of TD.MethodThis review followed PRISMA guidelines. We searched PubMed, Web of Science, Cochrane, and Embase up to September 2024 for clinical trials on TSORBT’s efficacy in TD. Two researchers independently screened studies, focusing on the Total Tic Severity Score of the Yale Global Tic Severity Scale (YGTSS-TTSS) and other subscores of the YGTSS-motor tic score (YGTSS-MTS), YGTSS-vocal tic score (YGTSS -VTS), YGTSS-impairment score and Parent Tic Questionnaire (PTQ). Risk of bias was assessed using Cochrane RoB 2. Data were analyzed in RevMan 5.4, with outcomes expressed as mean difference (MD) and 95% CI.ResultsIn total, 2764 articles were identified for screening. Nine studies involving 1049 participants, with 527 assigned to the TSORBT and 522 to the control were included. TSORBT exhibited potential in addressing YGTSS-TTSS (MD = -2.22, 95% CI: [-3.16, -1.29], P<0.00001), YGTSS-MTS (MD = -2.17, 95% CI: [-3.39, -0.96], P=0.0004), YGTSS-impairment score (MD= -1.69, 95% CI: [-3.26, -0.12], P=0.03) and PTQ score (MD= -6.05, 95% CI: [-8.65, -3.44], P<0.00001);. Subgroup analyses revealed that TSORBT demonstrated nearly the same efficacy as face-to-face BT in addressing YGTSS-TTSS (MD = -0.38, 95% CI: [-3.20, 2.43], P=0.79), but more effective than online psychoeducation (MD = -2.37, 95% CI: [-3.64, -1.10], P = 0.0002).ConclusionThe current study demonstrates the promising therapeutic efficacy of TSORBT in TD. Further rigorously designed studies, particularly those assessing long-term treatment durability, are warranted to consolidate the evidence base.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1521947/fulltic disordersticsbehavior therapyinternet-deliveredonline
spellingShingle Xiaolei Xu
Kangsheng Zhu
Weiyi Wang
Tianyu Zhao
Congrui Fu
Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis
Frontiers in Psychiatry
tic disorders
tics
behavior therapy
internet-delivered
online
title Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis
title_full Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis
title_fullStr Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis
title_full_unstemmed Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis
title_short Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis
title_sort efficacy of therapist supported online remote behavioral therapy for tic disorders a systematic review and meta analysis
topic tic disorders
tics
behavior therapy
internet-delivered
online
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1521947/full
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AT weiyiwang efficacyoftherapistsupportedonlineremotebehavioraltherapyforticdisordersasystematicreviewandmetaanalysis
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