[Perspective of peer helpers regarding their experience animating a self-treatment program for panic disorders]. / Perspective de pairs aidants sur leur expérience d'animation d'un programme d'autotraitement du trouble panique.

OBJECTIVE: Support groups can help to reach individuals with anxiety disorders who are not or are only partly obtaining health services. The present study is based on a program that involves peer helpers as animators of a self-treatment group (Zéro-ATAQ). Their perspective has been documented in order to identify the aspects of the program which can be improved. METHODS: Eleven peer helpers led the 12 sessions of the program, which was dispensed in four regions of Quebec for 32 persons having panic disorders with agoraphobia. The perspectives of ten peer animators were documented based on a semi-structured interview that took place at the end of the program, and a focus group that was held over six months later with peer animators from each of the groups. Their comments were transcribed and a thematic content analysis was conducted. RESULTS: All of the peer helper animators reported that they enjoyed participating in the program, that they appreciated being able to help others having an anxiety disorder, and that the program helped them in their role as animators of these types of activities. Nearly all of the peer helpers emphasized the importance of being able to count on the supervision of a professional when needed. CONCLUSION: This study revealed (1) the feasibility of implementing a program of this kind in partnership with peers, (2) the qualifications necessary to lead this type of program, (3) the requirements in terms of training and available material, and (4) the importance of supervision.

Cognitive aspects of hyperactivity and overactivity in preadolescents with tourette syndrome.

Attention deficit disorder with hyperactivity (ADHD) is a common comorbidity in children with Tourette syndrome (TS). However, motor restlessness and high levels of sensorimotor activation or "overactivity" may be a feature of TS rather than a distinct ADHD comorbidity. The link between overactivity and ADHD in TS has yet to be established and in particular between adult and preadolescent manifestations. The current study furthers this understanding of ADHD features in TS by investigating the relationship between cognitive and behavioral aspects of ADHD and TS. The style of planning (STOP) overactivity scale was compared in preadolescent (n = 17) and adult (n = 17) samples. The STOP overactivity scale measures the characteristic overactive style of planning in everyday life. The aims of the study were twofold as follows: (1) to see if an overactive style was present in adolescents as well as in adults, and (2) to see if this overactive style correlated with hyperactivity, impulsivity, or perfectionism. Results suggest that overactivity may be a better description of the hyperactivity manifestations in TS. Behavioral components of overactivity were present in preadolescents while the cognitive components were more frequent in adults. Overactivity relates at the same time to perfectionism and impulsivity.

[Barriers to treatment access reported by people with anxiety disorders]. / Obstacles de l'accès au traitement rapportés par des personnes aux prises avec un trouble anxieux.

OBJECTIVES: Our study examined the barriers to treatment experienced by people with anxiety disorders (ADs) who had not received services for their problems. Recommendations to improve treatment access made by participants are reported. METHOD: A web-based questionnaire on treatment accessibility for anxiety disorders was completed by 610 people living in Quebec reporting an anxiety problem. Chi-square tests were used to compare answers from people who received services (n = 151) with answers from people who had not (n = 434 ). RESULTS: Treatment wait times that were too long (X2 = 29.66, df = 1, P < 0.001 ), difficulties reaching a professional by phone (X2 = 13. 75, df = 1, P < 0.001 ), and geographical distance from service sites (X2 = 4.34, df = 1, P = 0.04) were obstacles that hindered participants who had not received the services they were seeking, more than those who had received services. CONCLUSIONS: Participant-reported barriers and recommendations highlight the need to increase access to health care professionals in terms of wait times, to train and inform primary care professionals about screening and treating ADs, and to develop psychotherapeutic services availability in the public health network.

Objective: Our study examined the barriers to treatment experienced by people with anxiety disorders (ADs) who had not received services for their problems. Recommendations to improve treatment access made by participants are reported. Method: A web-based questionnaire on treatment accessibility for anxiety disorders was completed by 610 people living in Quebec reporting an anxiety problem. Chi-square tests were used to compare answers from people who received services (n = 151) with answers from people who had not (n = 434). Results: Treatment wait times that were too long (χ2 = 29.66, df = 1, P < 0.001), difficulties reaching a professional by phone (χ2 = 13.75, df = 1, P < 0.001), and geographical distance from service sites (χ2 = 4.34, df = 1, P = 0.04) were obstacles that hindered participants who had not received the services they were seeking, more than those who had received services. Conclusions: Participant-reported barriers and recommendations highlight the need to increase access to health care professionals in terms of wait times, to train and inform primary care professionals about screening and treating ADs, and to develop psychotherapeutic services availability in the public health network.

Cognitive behavioral management of Tourette's syndrome and chronic tic disorder in medicated and unmedicated samples.

OBJECTIVE: Cognitive behavior therapy (CBT) and medication can be administered in combination in treating tic disorders but there are no studies evaluating the effectiveness of CBT with and without medication. The current study compares the efficacy of CBT in combination with medication and without medication. METHOD: CBT was administered in a consecutively referred sample of 76 people diagnosed either with Gilles de la Tourette Syndrome or chronic tic disorder. The sample was divided into a medicated and a non-medicated group. Twenty three were stabilized on medication and 53 were not receiving medication. Measures administered pre- and post-CBT in both groups included: main outcome measure of Tourette Syndrome Global Scale and measures of mood. RESULTS: Repeated measures analysis of variance on the initial sample revealed no difference between medicated and non-medicated groups in outcome. A further analysis comparing the 23 receiving medication with 23 not receiving medication matched on baseline clinical variables also yielded no significant group differences, either in treatment outcome on main tic outcome measures or on other clinically relevant questionnaires. DISCUSSION: CBT for tic disorders is an effective treatment administered either in combination with medication or alone.

Cognitive-behaviour therapy and skilled motor performance in adults with chronic tic disorder.

The first aim of the present study was to compare performance of people with tic disorders (TD) and controls on executive function and a range of skilled motor tests requiring complex performance, guided movements, hand co-ordination, and fine control of steadiness. The second aim was to investigate the effect of cognitive behaviour therapy (CBT) on motor performance. A total of 55 patients with TD were recruited at baseline from participants in a behavioural management programme. A comparison group of 55 patients suffering from a variety of habit disorders (HD) involving complex manual movements, were matched on age and level of education to 34 non-psychiatric controls. Participants were evaluated pre- and post-treatment and post-waitlist with a neuropsychological evaluation focusing on executive function (Wisconsin Card Sorting Test, WCST) and skilled motor performance (Purdue Pegboard, Hole Steadiness Test, and the Groove Test). Results revealed WCST scores in the normal range, while motor performance differed significantly on the Purdue Pegboard Tests in both TD and HD as compared to the control group. Cognitive-behavioural treatment selectively improved motor performance in both clinical groups compared to waitlist control, and this improvement related to clinical outcome measures.