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Practitioner Review: Treatments for Tourette syndrome in children and young people – a systematic review / Craig WHITTINGTON in Journal of Child Psychology and Psychiatry, 57-9 (September 2016)
[article]
Titre : Practitioner Review: Treatments for Tourette syndrome in children and young people – a systematic review Type de document : Texte imprimé et/ou numérique Auteurs : Craig WHITTINGTON, Auteur ; Mary PENNANT, Auteur ; Tim KENDALL, Auteur ; Cristine GLAZEBROOK, Auteur ; Penny TRAYNER, Auteur ; Madeleine GROOM, Auteur ; Tammy HEDDERLY, Auteur ; Isobel HEYMAN, Auteur ; Georgina JACKSON, Auteur ; Stephen JACKSON, Auteur ; Tara MURPHY, Auteur ; Hugh RICKARDS, Auteur ; Mary ROBERTSON, Auteur ; Jeremy STERN, Auteur ; Chris HOLLIS, Auteur Article en page(s) : p.988-1004 Langues : Anglais (eng) Mots-clés : Paediatrics Tourette syndrome therapy tics Index. décimale : PER Périodiques Résumé : Background Tourette syndrome (TS) and chronic tic disorder (CTD) affect 1–2% of children and young people, but the most effective treatment is unclear. To establish the current evidence base, we conducted a systematic review of interventions for children and young people. Methods Databases were searched from inception to 1 October 2014 for placebo-controlled trials of pharmacological, behavioural, physical or alternative interventions for tics in children and young people with TS or CTD. Certainty in the evidence was assessed with the GRADE approach. Results Forty trials were included [pharmacological (32), behavioural (5), physical (2), dietary (1)]. For tics/global score there was evidence favouring the intervention from four trials of ?2-adrenergic receptor agonists [clonidine and guanfacine, standardised mean difference (SMD) = ?0.71; 95% CI ?1.03, ?0.40; N = 164] and two trials of habit reversal training (HRT)/comprehensive behavioural intervention (CBIT) (SMD = ?0.64; 95% CI ?0.99, ?0.29; N = 133). Certainty in the effect estimates was moderate. A post hoc analysis combining oral clonidine/guanfacine trials with a clonidine patch trial continued to demonstrate benefit (SMD = ?0.54; 95% CI ?0.92, ?0.16), but statistical heterogeneity was high. Evidence from four trials suggested that antipsychotic drugs improved tic scores (SMD = ?0.74; 95% CI ?1.08, ?0.40; N = 76), but certainty in the effect estimate was low. The evidence for other interventions was categorised as low or very low quality, or showed no conclusive benefit. Conclusions When medication is considered appropriate for the treatment of tics, the balance of clinical benefits to harm favours ?2-adrenergic receptor agonists (clonidine and guanfacine) as first-line agents. Antipsychotics are likely to be useful but carry the risk of harm and so should be reserved for when ?2-adrenergic receptor agonists are either ineffective or poorly tolerated. There is evidence that HRT/CBIT is effective, but there is no evidence for HRT/CBIT alone relative to combining medication and HRT/CBIT. There is currently no evidence to suggest that the physical and dietary interventions reviewed are sufficiently effective and safe to be considered as treatments. En ligne : http://dx.doi.org/10.1111/jcpp.12556 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=292
in Journal of Child Psychology and Psychiatry > 57-9 (September 2016) . - p.988-1004[article] Practitioner Review: Treatments for Tourette syndrome in children and young people – a systematic review [Texte imprimé et/ou numérique] / Craig WHITTINGTON, Auteur ; Mary PENNANT, Auteur ; Tim KENDALL, Auteur ; Cristine GLAZEBROOK, Auteur ; Penny TRAYNER, Auteur ; Madeleine GROOM, Auteur ; Tammy HEDDERLY, Auteur ; Isobel HEYMAN, Auteur ; Georgina JACKSON, Auteur ; Stephen JACKSON, Auteur ; Tara MURPHY, Auteur ; Hugh RICKARDS, Auteur ; Mary ROBERTSON, Auteur ; Jeremy STERN, Auteur ; Chris HOLLIS, Auteur . - p.988-1004.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 57-9 (September 2016) . - p.988-1004
Mots-clés : Paediatrics Tourette syndrome therapy tics Index. décimale : PER Périodiques Résumé : Background Tourette syndrome (TS) and chronic tic disorder (CTD) affect 1–2% of children and young people, but the most effective treatment is unclear. To establish the current evidence base, we conducted a systematic review of interventions for children and young people. Methods Databases were searched from inception to 1 October 2014 for placebo-controlled trials of pharmacological, behavioural, physical or alternative interventions for tics in children and young people with TS or CTD. Certainty in the evidence was assessed with the GRADE approach. Results Forty trials were included [pharmacological (32), behavioural (5), physical (2), dietary (1)]. For tics/global score there was evidence favouring the intervention from four trials of ?2-adrenergic receptor agonists [clonidine and guanfacine, standardised mean difference (SMD) = ?0.71; 95% CI ?1.03, ?0.40; N = 164] and two trials of habit reversal training (HRT)/comprehensive behavioural intervention (CBIT) (SMD = ?0.64; 95% CI ?0.99, ?0.29; N = 133). Certainty in the effect estimates was moderate. A post hoc analysis combining oral clonidine/guanfacine trials with a clonidine patch trial continued to demonstrate benefit (SMD = ?0.54; 95% CI ?0.92, ?0.16), but statistical heterogeneity was high. Evidence from four trials suggested that antipsychotic drugs improved tic scores (SMD = ?0.74; 95% CI ?1.08, ?0.40; N = 76), but certainty in the effect estimate was low. The evidence for other interventions was categorised as low or very low quality, or showed no conclusive benefit. Conclusions When medication is considered appropriate for the treatment of tics, the balance of clinical benefits to harm favours ?2-adrenergic receptor agonists (clonidine and guanfacine) as first-line agents. Antipsychotics are likely to be useful but carry the risk of harm and so should be reserved for when ?2-adrenergic receptor agonists are either ineffective or poorly tolerated. There is evidence that HRT/CBIT is effective, but there is no evidence for HRT/CBIT alone relative to combining medication and HRT/CBIT. There is currently no evidence to suggest that the physical and dietary interventions reviewed are sufficiently effective and safe to be considered as treatments. En ligne : http://dx.doi.org/10.1111/jcpp.12556 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=292 Research Review: Childhood chronic physical illness and adult emotional health – a systematic review and meta-analysis / Ekin SECINTI in Journal of Child Psychology and Psychiatry, 58-7 (July 2017)
[article]
Titre : Research Review: Childhood chronic physical illness and adult emotional health – a systematic review and meta-analysis Type de document : Texte imprimé et/ou numérique Auteurs : Ekin SECINTI, Auteur ; Ellen J. THOMPSON, Auteur ; Marcus RICHARDS, Auteur ; Darya GAYSINA, Auteur Article en page(s) : p.753-769 Langues : Anglais (eng) Mots-clés : Depression anxiety chronic disorders meta-analysis paediatrics Index. décimale : PER Périodiques Résumé : Background Childhood chronic physical illness is associated with a greater vulnerability for emotional problems (i.e. depression and anxiety) in childhood. However, little is known about life-long effects of childhood chronic physical illness on mental health. The present study aims to systematically review evidence for associations between eight chronic physical illnesses with childhood onset (arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type 1 diabetes, and epilepsy) and adult emotional problems. Methods A database search of MEDLINE, PsycARTICLES, PsycINFO, and ScienceDirect was undertaken, and random effects meta-analyses were used to synthesise evidence from eligible studies. Results In total, 37 studies were eligible for the systematic review (n = 45,733) and of these, 34 studies were included in the meta-analyses (n = 45,358). There were overall associations between childhood chronic physical illness and adult depression (OR = 1.31; 95% CI [1.12, 1.54]) and anxiety (OR = 1.47; 95% CI [1.13, 1.92]). Separate meta-analyses for childhood asthma, type 1 diabetes and cancer were also conducted, with cancer being significantly associated with adult depression (OR = 1.19; 95% CI [1.00, 1.42]). Conclusions The effects of childhood chronic physical illness on the risk of emotional problems persist beyond childhood and adolescence. Mental health prevention and intervention strategies targeting children with chronic physical illnesses can have long-term benefits. En ligne : http://dx.doi.org/10.1111/jcpp.12727 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=316
in Journal of Child Psychology and Psychiatry > 58-7 (July 2017) . - p.753-769[article] Research Review: Childhood chronic physical illness and adult emotional health – a systematic review and meta-analysis [Texte imprimé et/ou numérique] / Ekin SECINTI, Auteur ; Ellen J. THOMPSON, Auteur ; Marcus RICHARDS, Auteur ; Darya GAYSINA, Auteur . - p.753-769.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 58-7 (July 2017) . - p.753-769
Mots-clés : Depression anxiety chronic disorders meta-analysis paediatrics Index. décimale : PER Périodiques Résumé : Background Childhood chronic physical illness is associated with a greater vulnerability for emotional problems (i.e. depression and anxiety) in childhood. However, little is known about life-long effects of childhood chronic physical illness on mental health. The present study aims to systematically review evidence for associations between eight chronic physical illnesses with childhood onset (arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type 1 diabetes, and epilepsy) and adult emotional problems. Methods A database search of MEDLINE, PsycARTICLES, PsycINFO, and ScienceDirect was undertaken, and random effects meta-analyses were used to synthesise evidence from eligible studies. Results In total, 37 studies were eligible for the systematic review (n = 45,733) and of these, 34 studies were included in the meta-analyses (n = 45,358). There were overall associations between childhood chronic physical illness and adult depression (OR = 1.31; 95% CI [1.12, 1.54]) and anxiety (OR = 1.47; 95% CI [1.13, 1.92]). Separate meta-analyses for childhood asthma, type 1 diabetes and cancer were also conducted, with cancer being significantly associated with adult depression (OR = 1.19; 95% CI [1.00, 1.42]). Conclusions The effects of childhood chronic physical illness on the risk of emotional problems persist beyond childhood and adolescence. Mental health prevention and intervention strategies targeting children with chronic physical illnesses can have long-term benefits. En ligne : http://dx.doi.org/10.1111/jcpp.12727 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=316