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心理干预对减轻成人注意力缺陷多动障碍(ADHD)注意力不集中症状的效果及可行性:一项系统评价

Effects and feasibility of psychological interventions to reduce inattention symptoms in adults with ADHD: a systematic review.

作者信息

Scholz Lisanne, Werle Jana, Philipsen Alexandra, Schulze Marcel, Collonges Julien, Gensichen Jochen

机构信息

Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany.

Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.

出版信息

J Ment Health. 2023 Feb;32(1):307-320. doi: 10.1080/09638237.2020.1818189. Epub 2020 Sep 21.

Abstract

BACKGROUND

Adult ADHD is common, highly comorbid, and restricts daily functioning. However, only a minority of patients receive appropriate treatment.

AIMS

Primary objective: To identify psychological interventions that diminish inattention symptoms in adults with ADHD. Secondary objective: To evaluate feasibility aspects.

METHODS

A search in PubMed, Cochrane Library, PsycInfo, PSYNDEX, and Eric was conducted. Interventions were grouped in: ADHD coaching, neuro feedback, cognitive training, psychoeducation, and behavioral therapy. Inattention symptoms were evaluated using standardized mean differences. Study quality was rated with the Cochrane Risk of Bias tool. Feasibility was assessed by number and time of sessions, setting, and qualification of the provider.

RESULTS

A total of N = 2229 results were identified, 19 randomized controlled studies were included in the analysis. Behavioral therapy showed effects on inattention symptoms [SMD: 0.44-1.71] when compared to inactive controls. In terms of feasibility, longer interventions did not outperform shorter ones and individual sessions were not superior to group sessions. No effects were given for neuro feedback, cognitive training, and psychoeducation in comparison to controls.

CONCLUSION

For adults with ADHD behavioral therapy seems an effective intervention to reduce inattention symptoms. In terms of feasibility, brief interventions may be valuable for a primary care setting.

摘要

背景

成人注意力缺陷多动障碍(ADHD)很常见,常伴有多种共病,且会限制日常功能。然而,只有少数患者接受了适当的治疗。

目的

主要目标:确定能减轻成人ADHD注意力不集中症状的心理干预措施。次要目标:评估可行性方面。

方法

在PubMed、Cochrane图书馆、PsycInfo、PSYNDEX和Eric中进行检索。干预措施分为:ADHD辅导、神经反馈、认知训练、心理教育和行为疗法。使用标准化均数差评估注意力不集中症状。研究质量用Cochrane偏倚风险工具进行评级。通过疗程数量和时间、环境以及提供者资质评估可行性。

结果

共识别出N = 2229条结果,19项随机对照研究纳入分析。与无干预对照组相比,行为疗法对注意力不集中症状有效果[标准化均数差:0.44 - 1.71]。在可行性方面,较长疗程的干预并不优于较短疗程的干预,个体治疗也不优于团体治疗。与对照组相比,神经反馈、认知训练和心理教育未显示出效果。

结论

对于成人ADHD患者,行为疗法似乎是减轻注意力不集中症状的有效干预措施。在可行性方面,简短干预对初级保健环境可能有价值。

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