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药物治疗的 ADHD 成人持续症状的认知行为疗法:一项随机对照试验。

Cognitive behaviour therapy in medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial.

机构信息

King's College London, Institute of Psychiatry, De Crespigny Park, London, UK.

出版信息

BMC Psychiatry. 2011 Jul 25;11:116. doi: 10.1186/1471-244X-11-116.

Abstract

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) in adulthood is not fully treated by psychopharmacological treatment alone. The main aim of the current study was to evaluate a newly developed cognitive behaviour therapy (CBT) based group programme, the Reasoning and Rehabilitation for ADHD Youths and Adults (R&R2ADHD), using a randomized controlled trial.

METHODS

54 adults with ADHD already receiving psychopharmacological treatment were randomly allocated to an experimental (CBT/MED) treatment condition (n = 27) and a 'treatment as usual' (TAU/MED) control condition (n = 27) that did not receive the CBT intervention. The outcome measures were obtained before treatment (baseline), after treatment and at three month follow-up and included ADHD symptoms and impairments rated by independent assessors, self-reported current ADHD symptoms, and comorbid problems.

RESULTS

The findings suggested medium to large treatment effects for ADHD symptoms, which increased further at three month follow-up. Additionally, comorbid problems also improved at follow-up with large effect sizes.

CONCLUSIONS

The findings give support for the effectiveness of R&R2ADHD in reducing ADHD symptoms and comorbid problems, an improving functions associated with impairment. The implications are that the benefits of R&R2ADHD are multifaceted and that combined psychopharmacological and CBT based treatments may add to and improve pharmacological interventions.

TRIAL REGISTRATION

ACTRN12611000533998 (http://www.ANZCTR.org.au/ACTRN12611000533998.aspx).

摘要

背景

成人注意缺陷多动障碍(ADHD)仅通过精神药理学治疗不能完全得到治疗。本研究的主要目的是通过随机对照试验评估一种新开发的基于认知行为疗法(CBT)的团体方案,即 Reasoning and Rehabilitation for ADHD Youths and Adults(R&R2ADHD)。

方法

54 名已接受精神药理学治疗的成年 ADHD 患者被随机分配到实验组(CBT/药物治疗)(n = 27)和对照组(“常规治疗/药物治疗”)(n = 27),后者未接受 CBT 干预。主要结局指标为治疗前(基线)、治疗后和 3 个月随访时由独立评估者评定的 ADHD 症状和损害、自我报告的当前 ADHD 症状和合并症问题。

结果

研究结果表明 ADHD 症状的治疗效果为中等到大,且在 3 个月随访时进一步增加。此外,合并症问题在随访时也有较大的改善。

结论

研究结果为 R&R2ADHD 降低 ADHD 症状和合并症问题、改善与损害相关的功能提供了有效性支持。这意味着 R&R2ADHD 的益处是多方面的,联合使用精神药理学和基于 CBT 的治疗可能会增加和改善药物干预的效果。

试验注册

ACTRN12611000533998(http://www.ANZCTR.org.au/ACTRN12611000533998.aspx)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e80/3155481/537e40a2c10d/1471-244X-11-116-1.jpg

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