Decoupling: adaptation of a treatment for body-focused repetitive behaviour to Tourette syndrome. A case report

Aims:Tourette syndrome (TS) is a neurological condition; its etiology is not yet fully understood. Cognitive behavioural therapy with habit reversal training is the recommended first-line treatment, but is not effective in all patients. This is the first report examining the usefulness of decoupling, a behavioural self-help treatment originally developed for patients with body-focused repetitive behaviours, in a patient with TS. Method:Patient P.Z. showed 10 motor and three vocal tics on the Adult Tic Questionnaire (ATQ) before treatment. He was taught decoupling by the first author. Results:The application of decoupling led to a reduction of P.Z.'s eye tics, which was one of his first and most enduring and severe tics. It was not effective for other areas. Quality of life and depression improved, which P.Z. attributed to the improvement of his tics. Conclusion:Decoupling may be adopted as an alternative, when habit reversal training is not feasible. Future research, preferably using a controlled design with a large sample, may elucidate whether decoupling is only effective for tics relating to the eyes, the most common symptom in tic disorder/TS, or whether its effects extend to other symptoms.

Automated summary

This study examines the usefulness of decoupling, a behavioral self-help treatment, in a patient with Tourette syndrome. The results show that decoupling is effective in reducing eye tics, but not effective for other symptoms. The study suggests that decoupling can be considered as an alternative treatment when habit reversal training is not feasible.