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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)

2026년 7월 23일 업데이트: 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 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.

연구 개요

상세 설명

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 will be assessed using the Yale Global Tic Severity Scale (YGTSS) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) by an independent clinician at the start of treatment, at Week 12, and again at Week 24.

연구 유형

중재적

등록 (추정된)

40

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 장소

    • London
      • London, London, 영국, WC1N 3BG
        • 모병
        • University College London Queen Square Institute of Neurology
        • 연락하다:
        • 수석 연구원:
          • Himanshu Tyagi, PhD
      • London, London, 영국, WC1N 3BG
        • 모병
        • University College London Hospitals NHS Foundation Trust
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  1. Age 18 years or older
  2. All genders
  3. Confirmation of a primary diagnosis of either:

a. Tourettes Disorder / Tourette Syndrome b. Persistent Motor or Vocal Tic Disorder / Chronic Motor or Vocal Tic Disorder c. Provisional Tic Disorder / Transient Motor Tics d. Other Specified Tic Disorder e. Unspecified Tic Disorder f. Obsessive-Compulsive Disorder [d] Participants taking psychotropic medication are eligible provided medication type and dose remain stable throughout the 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
  2. Current diagnosis of a personality disorder
  3. Schizophrenia
  4. Bipolar disorder
  5. Contraindications to participation in a trial (i.e., active suicidal ideations and/or requirement of an interpreter)
  6. Any psychiatric or neurological condition that, in the opinion of the investigators, would interfere with participation or interpretation of study outcomes.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 하나의

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 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.
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.
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.
활성 비교기: 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.
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.
활성 비교기: Standardised Exposure and Response Prevention
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.
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.
활성 비교기: Standardised Habit Reversal
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.
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.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change From Baseline in Yale-Brown Obsessive Compulsive Scale Total Score
기간: Baseline, Week 12 and Week 24
Obsessive-compulsive symptom severity will be assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Total scores range from 0 to 40, with higher scores indicating greater obsessive-compulsive symptom severity. Change from baseline will be assessed at Week 12 and Week 24.
Baseline, Week 12 and Week 24
Change From Baseline in Yale Global Tic Severity Scale Total Tic Severity Score
기간: Baseline, Week 12 and Week 24
Tic symptom severity will be assessed using the Yale Global Tic Severity Scale (YGTSS) Total Tic Severity Score. Scores range from 0 to 50, with higher scores indicating greater tic symptom severity. Change from baseline will be assessed at Week 12 and Week 24.
Baseline, Week 12 and Week 24

2차 결과 측정

결과 측정
측정값 설명
기간
Change From Baseline in Yale Global Tic Severity Scale Global Severity Score
기간: Baseline, Week 12 and Week 24
Overall tic symptom severity and tic-related impairment will be assessed using the Yale Global Tic Severity Scale (YGTSS) Total Score. The Global Score is calculated by summing the Total Tic Severity Score (0-50) and the Impairment Score (0-50), resulting in a global score ranging from 0 to 100. Higher scores indicate greater overall tic severity and impairment. Change from baseline will be assessed at Week 12 and Week 24.
Baseline, Week 12 and Week 24

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2026년 7월 8일

기본 완료 (추정된)

2027년 8월 1일

연구 완료 (추정된)

2030년 2월 1일

연구 등록 날짜

최초 제출

2026년 7월 21일

QC 기준을 충족하는 최초 제출

2026년 7월 21일

처음 게시됨 (실제)

2026년 7월 24일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 7월 27일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 7월 23일

마지막으로 확인됨

2026년 7월 1일

추가 정보

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