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一项针对患有注意力缺陷多动障碍(ADHD)的成年人的互联网自助干预措施:一项随机对照试验的结果。

A self-guided internet-delivered intervention for adults with ADHD: Results from a randomized controlled trial.

作者信息

Kenter Robin Maria Francisca, Gjestad Rolf, Lundervold Astri J, Nordgreen Tine

机构信息

Division of Psychiatry, Haukeland University Hospital, Haukelandsbakken 15, 5009 Bergen, Norway.

Research Department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.

出版信息

Internet Interv. 2023 Mar 20;32:100614. doi: 10.1016/j.invent.2023.100614. eCollection 2023 Apr.

Abstract

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) in adulthood, with an estimated prevalence of 2-3 %, is associated with several challenges in daily life functioning. Still, the availability of evidence-based psychological interventions for adults with ADHD is limited. Interventions delivered over the Internet on smartphones or personal computers may help to increase the availability of and access to effective psychological interventions.

OBJECTIVE

This study reports on the efficacy of a self-guided psychological Internet-delivered intervention on severity levels of ADHD symptomatology and quality of life in adults with ADHD.

METHODS

Adults with a self-reported ADHD diagnosis ( = 120) were included in a randomized controlled trial with two arms: 1) self-guided Internet-delivered intervention for managing symptoms and impairments related to ADHD ( = 61); 2) online psychoeducation module (control group,  = 59). The primary clinical outcome was severity levels of ADHD as measured with the Adult ADHD Self-Report Scale. Secondary outcomes were quality of life as measured with the Adult ADHD Quality of Life scale and stress as measured with the Perceived Stress Scale. Measures were obtained at three time points: before (baseline), immediately after (8 weeks) and 3 months after the intervention. The secondary objective of the study was to explore user satisfaction with and adherence to the intervention.

RESULTS

Linear Mixed Model analysis revealed moderate to large between group effect-size improvements on self-report measures of ADHD symptomatology ( = 0.70) and quality of life ( = 0.53). Importantly, effects were maintained at 3-month follow-up ( = 0.76 and  = 0.52). In terms of adherence, 29 % completed all modules, while 59 % completed at least five modules (out of 7). Treatment satisfaction was adequate, with  = 34 (79 %) indicating that they were very satisfied or satisfied with the intervention, and  = 37 (88 %) indicating that they would recommend the intervention to a friend.

DISCUSSION

The study demonstrated the efficacy of a self-guided Internet-delivered intervention by showing reliable and statistically significant improvements in self-reported ADHD symptomatology and quality of life. The intervention may be suitable for better managing ADHD symptoms in primary care and as a low intensity intervention population wide.

TRIAL REGISTRATION

ClinicalTrials.gov, Identifier NCT04726813, January 27, 2021.

摘要

背景

成人注意力缺陷多动障碍(ADHD)的患病率估计为2%-3%,与日常生活功能方面的诸多挑战相关。然而,针对成年ADHD患者的循证心理干预措施有限。通过智能手机或个人电脑在互联网上提供的干预可能有助于增加有效心理干预措施的可及性和获取途径。

目的

本研究报告一种自我引导的互联网心理干预措施对成年ADHD患者ADHD症状严重程度和生活质量的疗效。

方法

自我报告诊断为ADHD的成年人(n = 120)被纳入一项双臂随机对照试验:1)用于管理与ADHD相关症状和损害的自我引导互联网干预措施(n = 61);2)在线心理教育模块(对照组,n = 59)。主要临床结局是用成人ADHD自我报告量表测量的ADHD严重程度。次要结局是用成人ADHD生活质量量表测量的生活质量和用感知压力量表测量的压力。在三个时间点进行测量:干预前(基线)、干预后即刻(8周)和干预后3个月。该研究 的次要目的是探索用户对干预措施的满意度和依从性。

结果

线性混合模型分析显示,在ADHD症状自我报告测量(d = 0.70)和生活质量(d = 0.53)方面,组间效应量有中度到较大改善。重要的是,在3个月随访时效果得以维持(d = 0.76和d = 0.52)。在依从性方面,29%的人完成了所有模块,而59%的人至少完成了7个模块中的5个。治疗满意度良好,n = 34(79%)表示他们对干预措施非常满意或满意,n = 37(88%)表示他们会向朋友推荐该干预措施。

讨论

该研究通过显示自我报告的ADHD症状和生活质量有可靠且具有统计学意义的改善,证明了一种自我引导的互联网干预措施的疗效。该干预措施可能适合在初级保健中更好地管理ADHD症状,并作为一种低强度的广泛人群干预措施。

试验注册

ClinicalTrials.gov,标识符NCT04726813,2021年1月27日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/493b/10033990/07f88ebf641e/gr1.jpg

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