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INTEGRATING EXPOSURE AND RESPONSE PREVENTION AND HABIT REVERSAL TECHNIQUES TO TREAT A TOURETTIC SUBTYPE OF OBSESSIVE-COMPULSIVE DISORDER (TOURETTIC OCD). (TORCH)

21. juli 2026 opdateret af: Dipesh Patel, University College London Hospitals
Obsessive-Compulsive Disorder and Tic Disorders frequently co-occur, and a subgroup of patients - those with a Tourettic Subtype of OCD (TOCD) - present with symptoms of both conditions simultaneously. Standard interventions typically address 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.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Participants are randomly allocated to one of four groups: (1) combined ERP and HbRT, (2) ERP alone, (3) HbRT alone, or (4) a supportive psychoeducation control. All participants receive 12 weekly one-to-one sessions (either in-person or remotely) of approximately fifty minutes. Symptoms (as measured by the YGTSS and YBOCS) are assessed by an independent clinician at the start of treatment, at week-12, and again at week-24.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

40

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Det Forenede Kongerige
    • London
      • London, London, Det Forenede Kongerige, WC1N 3BG
        • Rekruttering
        • University College London Queen Square Institute of Neurology
        • Kontakt:
        • Ledende efterforsker:
          • Himanshu Tyagi, PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Age > 18 years.
  2. Either Gender
  3. Confirmation of a primary diagnosis of either:

a. Tourette's Disorder (DSM-5 307.23 F95.2) b. Persistent Motor or Vocal Tic Disorder (DSM-5 307.22 F95.1) c. Provisional Tic Disorder (DSM-5 307.21 F95.0) d. Other Specified Tic Disorder (DSM-5 307.20 F95.8) e. Unspecified Tic Disorder (DSM-5 307.20 F95.9) f. Obsessive-Compulsive Disorder (DSM-5 300.3 F42.2) [d] Medication use is not an exclusion criterion (type of medication and daily dosages are to remain unchanged throughout the trial intervention period) [e] Ability to provide sustained informed consent [f] A minimum score of 16 on YBOCS [g] A minimum score of 5 on the Premonitory Urge for Tics Scale (PUTS)

Exclusion Criteria:

  1. Substance misuse (DSM 483)
  2. Adult personality disorder (DSM 645) (301.0 - 301.9)
  3. Schizophrenia (DSM 297.1 - 298.9)
  4. Bipolar disorder (DSM 296.89 - 296.80)
  5. Contraindications to participation in a trial (i.e., active suicidal ideations and/or requirement of an interpreter)
  6. Other diagnostic contraindication(s)

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Combined Exposure and Response Prevention and Habit Reversal
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.
Adfærdsmæssigt: Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) is a behavioural intervention that involves 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. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.
Adfærdsmæssigt: Habit Reversal Training (HbRT
Habit Reversal Training (HbRT) is a behavioural intervention that includes awareness training, identification of premonitory urges and antecedents to tic expression, development and practice of competing responses, and strategies to generalise skills across settings. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.
Aktiv komparator: Standarised Exposure and Response Prevention Alone
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.
Adfærdsmæssigt: Exposure and Response Prevention (ERP)
Exposure and Response Prevention (ERP) is a behavioural intervention that involves 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. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.
Aktiv komparator: Standarised Habit Reversal Alone
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.
Adfærdsmæssigt: Habit Reversal Training (HbRT
Habit Reversal Training (HbRT) is a behavioural intervention that includes awareness training, identification of premonitory urges and antecedents to tic expression, development and practice of competing responses, and strategies to generalise skills across settings. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.
Aktiv komparator: Psychoeducation / Supportive Intervention
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.
Adfærdsmæssigt: Psychoeducation and Supportive Intervention
Psychoeducation and Supportive Therapy consists of structured education about obsessive-compulsive disorder, tic disorders, Tourettic obsessive-compulsive disorder, stress, and wellbeing, together with supportive discussion and general problem-solving. The intervention does not include Exposure and Response Prevention, Habit Reversal Training, or other targeted behavioural techniques. Treatment is delivered individually over 12 weekly 50-minute sessions, either face-to-face or remotely.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change From Baseline in Yale-Brown Obsessive Compulsive Scale Total Score
Tidsramme: Baseline, Week 12 and Week 24
Obsessive-compulsive symptom severity will be measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The Y-BOCS total score ranges from 0 to 40, with higher scores indicating greater obsessive-compulsive symptom severity. Change from baseline will be assessed at the end of treatment and follow-up.
Baseline, Week 12 and Week 24
Change From Baseline in Yale Global Tic Severity Scale Total Tic Severity Score
Tidsramme: Baseline, Week 12 and Week 24
Tic symptom severity will be measured using the Yale Global Tic Severity Scale (YGTSS) Total Tic Severity Score. The score ranges from 0 to 50, with higher scores indicating greater tic severity. Change from baseline will be assessed at the end of treatment and follow-up.
Baseline, Week 12 and Week 24

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change From Baseline in Yale-Brown Obsessive Compulsive Scale Impairment Score
Tidsramme: Baseline, Week 12 and Week 24
Functional impairment associated with obsessive-compulsive symptoms will be measured using the impairment items of the Yale-Brown Obsessive Compulsive Scale. Higher scores indicate greater impairment. Change from baseline will be assessed at the end of treatment and follow-up.
Baseline, Week 12 and Week 24
Change From Baseline in Yale Global Tic Severity Scale Impairment Score
Tidsramme: Baseline, Week 12 and Week 24
Tic-related functional impairment will be measured using the Yale Global Tic Severity Scale Impairment Score. The score ranges from 0 to 50, with higher scores indicating greater impairment. Change from baseline will be assessed at the end of treatment and follow-up.
Baseline, Week 12 and Week 24

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University College London Hospitals

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

8. juli 2026

Primær færdiggørelse (Anslået)

1. august 2027

Studieafslutning (Anslået)

1. februar 2030

Datoer for studieregistrering

Først indsendt

21. juli 2026

Først indsendt, der opfyldte QC-kriterier

21. juli 2026

Først opslået (Faktiske)

24. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

21. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • ERP/HR TOCD RTC - 177187

Plan for individuelle deltagerdata (IPD)

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Kliniske forsøg med Tic lidelser

Kliniske forsøg med Exposure and Response Prevention (ERP)

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Sponsorer og samarbejdspartnere

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Betingelser

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Placeringer

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