University of British Columbia, Faculty of Medicine, 1488 Gordon Ave, West Vancouver, BC V7T 1R6, Canada.
BMC Psychiatry. 2012 Apr 5;12:30. doi: 10.1186/1471-244X-12-30.
Previous studies of psychological treatment in adults with ADHD have not controlled for medication status and include either medicated participants or mixed samples of medicated and unmedicated participants. The objective of this study is to examine whether use of medication improves outcome of therapy.
This was a secondary analysis comparing 23 participants randomized to CBT and Dextroamphetamine vs. 25 participants randomized to CBT and placebo. Both patients and investigators were blind to treatment assignment. Two co-primary outcomes were used: ADHD symptoms on the ADHD-RS-Inv completed by the investigator and improvement in functioning as reported by the patient on the Sheehan Disability Scale.
Both groups showed robust improvement in both symptoms and functioning, but the use of medication did not significantly improve outcome over and above use of CBT and placebo.
This study replicates previous work demonstrating that CBT is an effective treatment for ADHD in adults. Within the limits of this pilot, secondary analysis we were not able to demonstrate that medication significantly augments the outcome of CBT therapy for adults with ADHD. The study was funded by GlaxoSmithKline, Clinical Trials Registry #GSK707.
之前对成年 ADHD 患者进行心理治疗的研究并未控制药物治疗状态，包括使用药物的参与者或使用药物和未使用药物的混合样本的参与者。本研究的目的是检验使用药物是否能改善治疗效果。
这是一项对 23 名随机分配至 CBT 和右旋苯丙胺的参与者与 25 名随机分配至 CBT 和安慰剂的参与者进行的二次分析。患者和研究者均对治疗分配情况不知情。使用两个主要结局指标进行比较：研究者完成的 ADHD-RS-Inv 上的 ADHD 症状和患者在 Sheehan 残疾量表上报告的功能改善情况。
两组在症状和功能方面均显示出显著改善，但与使用 CBT 和安慰剂相比，使用药物并不能显著提高治疗效果。
本研究复制了之前的工作，证明 CBT 是治疗成人 ADHD 的有效方法。在本研究的限制范围内，二次分析结果未能表明药物治疗能显著增强 ADHD 成人 CBT 治疗的效果。本研究由葛兰素史克公司资助，临床试验注册号为 GSK707。
