A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with attention-deficit/hyperactivity disorder (ADHD)
A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with attention-deficit/hyperactivity disorder (ADHD)
复制标题
认知行为疗法（CBT）与CBT联合药物治疗成人注意力缺陷/多动障碍（ADHD）的疗效比较
DOI：
10.1016/j.psychres.2019.06.040
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发表时间：
2019-09-01
影响因子：
11.3
通讯作者：
Qian Qiu-Jin
中科院分区：
文献类型：
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作者：
Pan Mei-Rong;Huang Fang;Qian Qiu-Jin
该研究旨在探讨认知行为疗法（CBT）联合药物治疗在成人注意缺陷/多动障碍（ADHD）患者的核心症状、情绪症状、自尊以及社会和认知功能方面是否优于单独使用CBT。纳入了先前一项随机对照试验研究的样本以及门诊参与者。共有124名患者接受了为期12周的标准化CBT疗程，其中57名患者同时接受药物治疗，67名患者不接受药物治疗。在基线以及每周对疗效变量进行评估。采用混合线性模型（MLM）比较两组在上述所有方面的差异。组内比较显示，两组在ADHD核心症状、情绪症状和社会功能结果方面均有显著改善。CBT +药物治疗组在执行功能的更多方面比CBT组有改善。然而，组间比较并未表明CBT +药物治疗在核心症状、情绪症状和自尊方面具有优势。相反，CBT组在世界卫生组织生存质量测定简表（WHOQOL - BREF）的身体领域比CBT +药物治疗组有更大改善。这项研究进一步表明，CBT是治疗成人ADHD的一种有效方法。与单独使用CBT相比，CBT与药物联合治疗在执行功能方面有更广泛的改善，但在临床症状方面则没有。
The study aimed to explore whether cognitive behavioral therapy (CBT) combined with medication is superior to CBT alone in core symptoms, emotional symptoms, self-esteem as well as social and cognitive functions of adult attention-deficit/hyperactivity disorder (ADHD) patients. Samples from a previous RCT study and outpatient participants were all included. A total of 124 patients received 12 weeks of manualized CBT sessions, either with (n = 57) or without (n = 67) medication. Efficacy variables were evaluated at baseline and each week. Mixed linear models (MLM) were used to compare differences between the two groups in all of the above domains. Within-group comparisons showed that both groups had robust improvements in core ADHD symptoms, emotional symptoms and social functional outcomes. The CBT + M group presented more domains of improvement in executive functions than the CBT group. However, comparisons between groups didn't indicate the superiority of CBT + M in core symptoms, emotional symptoms and self-esteem. Instead, the CBT group showed a greater improvement in the physical domain of the WHOQOL-BREF than the CBT + M group. This study further indicated that CBT is an effective treatment for adults with ADHD. A combination of CBT and medication presented broader improvements in executive functions, but not in clinical symptoms, than CBT alone.