Cognitive-Behavioural Therapy (CBT) for Adult Attention Deficit Hyperactivity Disorder (ADHD)
Condition: Attention Deficit Hyperactivity Disorder
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      The purpose of the study is to compare the effectiveness of cognitive-behavioural therapy
      (CBT) plus treatment as usual with treatment as usual only in treating adults with attention
      deficit hyperactivity disorder (ADHD).
    

Detailed description: 
      Approximately 50% of individuals with adult ADHD are not able to tolerate, do not respond to,
      or fail to reach optimal outcomes on medication alone (Spencer, Biederman and Wilens 2000).
      The NICE guidelines for adult ADHD, released in September 2008, emphasise the need for
      further such research into psychological approaches to treatment of the condition.

      There is promising preliminary evidence that suggests that psychological approaches to
      treatment are effective in individuals with Adult ADHD (see Weiss et al 2008 for a review).
      So far, however, only one randomised controlled trial of CBT has been carried out (Safren,
      Otto et al 2005). Thirty-one participants were randomised to receive either CBT and
      medication as usual or medication alone. Those randomised to CBT (n=16) had significantly
      lower ADHD symptoms (as rated by an independent investigator), global severity and self-rated
      symptoms than those on medication only (ps range <0.01 to <0.002). Those in the CBT group
      also had significantly lower scores on independently- and self-rated measures of mood (ps
      range <0.01 to 0.04).

      There is a need for more randomised controlled trials to be carried out in order to replicate
      Safren et al's result in a different site, to further investigate the feasibility of CBT in
      this population and to further develop CBT approaches to this condition.

      Studies carried out so far have tended to be skills-based (i.e. sessions focused on teaching
      specific skills such as time management), rather than formulation-driven (a formulation is
      essentially a shared hypothesis as to the relationships between the individual's experience,
      beliefs, behaviour and emotions).

      The current study aims to evaluate a formulation-driven approach to CBT for adults with ADHD.
      A group of individuals (n = 30) receiving CBT combined with treatment as usual for adults
      with ADHD will be compared with a group receiving treatment as usual only (n= 30), employing
      a randomized design.
    

Intervention name(s): CBT plus treatment as usual; Treatment as usual
Intervention type(s): Other; Other
Intervention description(s): 16 one-hour therapy sessions taking place over 42 weeks in addition to usual medical follow-up appointments; Treatment as usual appointments at the Adult ADHD Service - typically one 30-minute appointment every three to six months
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Adult attention deficit hyperactivity disorder; cognitive-behavioural therapy; randomised controlled trial