August 27, 2010

Study: Cognitive Behavioral Therapy Works For Adult ADHD

(Ivanhoe Newswire) -- Adults with attention-deficit/hyperactive disorder (ADHD) are showing greater improvement when receiving individual sessions of cognitive behavioral therapy (CBT) in addition to their monthly medication.

"Approximately 4.4 percent of adults in the United States with ADHD, which is a disorder characterized by impairing levels of inattention, hyperactivity, and impulsivity. Medications have been the primary treatment; however, many adults with ADHD cannot or will not take medications while others show a poor medication response.  Furthermore, those considered responders to medications (i.e., 30 percent symptom reduction) may continue to experience significant and impairing symptoms.  Thus there is a need for alternative and next-step strategies," study authors were quoted as saying.

The study, conducted between November 2004 and June 2008 (with follow-up through July 2009) by Stephen A. Safren, PhD, A.B.P.P., of Massachusetts General Hospital, Boston, tested CBT for ADHD in 86 adults -- in which only 70 completed the follow-up assessments -- treated with monthly medication yet still had significant symptoms.  The patients were randomized to 12 individual sessions of either CBT or relaxation with educational support.

CBT included sessions focusing heavily on psycho-education about ADHD and training in organizing and planning.  Some of these include but are not limited to: learning skills to help reduce distractibility; cognitive restructuring; and relapse prevention.  Prior to the treatment, ADHD symptoms were rated by an assessor using a precise rating scale as well as a Clinical Global Impressions (CGI) scale.  This routine was repeated at 6-month and 12-month follow-ups and once again at the conclusion of each patients treatment.

Patients who completed treatment implementing CBT had significantly better ADHD rating scale scores (67 percent vs. 33 percent) and CGI scale scores (53 percent vs. 23 percent) than those assigned to relaxation with educational support.  In addition, self-reported symptoms were notably more improved for CBT and maintained there gains over 6 and 12 months.

"The study suggests that cognitive behavioral therapy for ADHD in adults appears to be a useful and efficacious next step strategy for adults who show continued symptoms despite treatment with medication.  Generally, the treatment was well tolerated, with very low drop-out rates, and had positive and sustainable effects on ADHD symptoms. Clinical application of these strategies to patients in need is encouraged," study authors conclude.

SOURCE: Journal of the American Medical Association