Cognitive behavioral therapy for treatment of adult ADHD

January 01, 0001

Cognitive behavioral therapy for treatment of adult ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a condition increasingly being diagnoses in adults, but which is lacking evidence-based psychosocial treatments. These US researchers performed a randomized controlled trial examining cognitive behavioral therapy for 86 symptomatic adults with ADHD who were being treated with pharmacotherapy. Participants were randomized to 12 individual sessions of either cognitive behavioral therapy or relaxation with educational support The primary outcome measures were ADHD symptoms rated by a blinded assessor using the ADHD rating scale and Clinical Global Impression scale) at baseline, posttreatment, and at 6- and 12- month follow-up. Self-report of symptoms was a secondary measure.

The researchers found: "Cognitive behavioral therapy achieved lower posttreatment scores on both the Clinical Global Impression scale (magnitude -0.0531) and the ADHD rating scale (magnitude -4.631) compared with relaxation with educational support. Throughout treatment, self-reported symptoms were also significantly more improved for cognitive behavioral therapy (Beta= -0.41), and there were more treatment responders in cognitive behavioral therapy for both the Clinical Global Impression scale (53% vs 23%, odds ratio {OR} 3.80) and the ADHD rating scale (67% vs 33%, OR 4.29). Responders and partial responders in the cognitive behavioral therapy condition maintained their gains over 6 and 12 months."

The researchers concluded: "Among adults with persistent ADHD symptoms treated with medication, the use of cognitive behavioral therapy compared with relaxation with educational support resulted in improved ADHD symptoms, which were maintained at 12 months."

This small study suggests there may be a significant role for cognitive behavioral therapy as an adjunctive treatment of ADHD in adults

For the full abstract, click here.

JAMA 304(8):875-880, 25 August 2010
© 2010 American Medical Association
Cognitive Behavioral Therapy vs Relaxation With Educational Support for Medication-Treated Adults With ADHD and Persistent Symptoms: A Randomized Controlled Trial. Steven A. Safren, Susan Sprich, Matthew J. Mimiaga, et al.

Category: P. Psychological. Keywords: ADHD, adults, cognitive behavioral therapy, relaxation, pharmacotherapy, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 10 September 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.