Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK.
Psychol Med. 2020 Mar;50(4):529-541. doi: 10.1017/S0033291720000069. Epub 2020 Feb 10.
Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder, often persisting into adulthood. Whilst medication is first-line treatment for ADHD, there is a need for evidence-based non-pharmacological treatment options for adults with ADHD who are either still experiencing significant symptoms or for those who have made the informed choice not to start medication.
We systematically searched PsycINFO, MEDLINE (Ovid), EMBASE, CINAHL and CENTRAL for randomised controlled trials of non-pharmacological treatments for ADHD in adults. After screening of titles and abstracts, full text articles were reviewed, data extracted and bias assessed using a study proforma.
There were 32 eligible studies with the largest number of studies assessing cognitive behavioural therapy (CBT). CBT consisted of either group, internet or individual therapy.
The majority found an improvement in ADHD symptoms with CBT treatment. Additionally, mindfulness and cognitive remediation have evidence as effective interventions for the core symptoms of ADHD and there is evidence for the use of group dialectical behavioural therapy and hypnotherapy. However, evidence for these is weaker due to small numbers of participants and limitations due to the lack of suitable control conditions, and a high risk of bias.
注意力缺陷多动障碍（ADHD）是一种常见的发育障碍，常持续到成年。虽然药物治疗是 ADHD 的一线治疗方法，但对于仍有明显症状的成年人或出于知情选择而未开始药物治疗的成年人，需要有基于证据的非药物治疗选择。
我们系统地在 PsycINFO、MEDLINE（Ovid）、EMBASE、CINAHL 和 CENTRAL 中搜索了针对成人 ADHD 的非药物治疗的随机对照试验。在筛选标题和摘要后，我们使用研究方案审查全文文章、提取数据并评估偏倚。
有 32 项符合条件的研究，其中评估认知行为疗法（CBT）的研究数量最多。CBT 包括团体、互联网或个体治疗。
大多数研究发现 CBT 治疗可改善 ADHD 症状。此外，正念和认知矫正被证明是 ADHD 核心症状的有效干预措施，有证据表明团体辩证行为疗法和催眠疗法也有效。然而，由于参与者人数较少以及由于缺乏合适的对照条件和高偏倚风险导致的限制，这些证据较弱。
