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Corbisiero S, Bitto H, Newark P, Abt-Mörstedt B, Elsässer M, Buchli-Kammermann J, Künne S, Nyberg E, Hofecker-Fallahpour M, Stieglitz RD. A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)-A Randomized Controlled Trial. Front Psychiatry 2018; 9:571. [PMID: 30505283 PMCID: PMC6250816 DOI: 10.3389/fpsyt.2018.00571] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/19/2018] [Indexed: 11/13/2022] Open
Abstract
In the treatment of adult attention-deficit/hyperactivity disorder (ADHD) the importance of psychological interventions in combination with pharmacotherapy is widely accepted in contemporary clinical routine. The natural course of the disorder seems to justify additional psychological interventions because even in patients who are highly compliant to pharmacotherapy full remission is not always achieved. The aim of the present study was to analyze the contribution of psychotherapy to the treatment of adult ADHD patients. In a randomized controlled study, the efficacy of a combined treatment of psychotherapy with pharmacotherapy is compared to pharmacological intervention alone. After initiation and stabilization of treatment with methylphenidate (MPH) in all subjects randomization to the two different treatment conditions was done. Afterwards both groups underwent treatment for about 10-12 weeks, the experimental group receiving sessions of cognitive-behavioral therapy (CBT) whereas the control group only received medication and standard clinical management (SCM). ADHD symptoms differed statistically during time but not between the two different treatment conditions. This result was the same for the single ADHD symptoms-inattention, hyperactivity, impulsivity, and emotional symptoms-and also for impairment. Individual standardized ADHD specific CBT program was not able to outperform SCM.
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Affiliation(s)
- Salvatore Corbisiero
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Hannes Bitto
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Patricia Newark
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Beatrice Abt-Mörstedt
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Marina Elsässer
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Jacqueline Buchli-Kammermann
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Sven Künne
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Elisabeth Nyberg
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Maria Hofecker-Fallahpour
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Rolf-Dieter Stieglitz
- Division of Clinical Psychology and Psychiatry, University of Basel Psychiatric Clinics, Basel, Switzerland.,Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
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Nyberg E, Stieglitz RD. Psychotherapie der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Erwachsenenalter. ACTA ACUST UNITED AC 2006. [DOI: 10.1024/1661-4747.54.2.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Wenngleich in der Behandlung der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Erwachsenenalter die medikamentöse Behandlung mit Stimulanzien die Grundlage darstellt, können psychosoziale Interventionen in Kombination mit der Pharmakotherapie einen wichtigen Beitrag zur lebenslangen Bewältigung der Störung leisten. Ein multimodales Programm sollte daher Medikation und Psychotherapie umfassen. Im Beitrag soll ein Überblick zu den verschiedenen psychosozialen Behandlungsansätzen der ADHS im Erwachsenenalter und deren Wirksamkeit gegeben werden. Die Ergebnisse von Studien unterstreichen, dass in Kombination mit einer Medikation Verbesserungen der Kernsymptomatik zu erreichen sind. Aufgrund zum Teil großer methodischer Probleme der meisten Studien sind jedoch weitere kontrollierte Studien notwendig.
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