Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms
Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms
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DOI：
10.1016/j.brat.2004.07.001
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发表时间：
2005-07-01
影响因子：
4.1
通讯作者：
Biederman, J
中科院分区：
文献类型：
--
作者：
Safren, SA;Otto, MW;Biederman, J
本研究的目的是检验一种新型认知行为疗法 (CBT) 对于患有注意力缺陷多动障碍 (ADHD) 的成人患者的潜在疗效、患者可接受性和可行性，这些患者已通过药物稳定但仍表现出临床显着症状。 31 名患有 ADHD 且 ADHD 精神药理学稳定的成人被随机分配接受 CBT 加继续精神药理学或仅继续精神药理学。评估包括由独立评估员 (IE) 和自我报告评估的 ADHD 严重程度以及相关的焦虑和抑郁。在结果评估中，与随机接受单独继续精神药理学治疗的患者相比，随机接受 CBT 治疗的患者的 IE 评级 ADHD 症状 (p < .01) 和总体严重程度 (p < .002) 以及自我报告的 ADHD 症状 (p < .0001) 较低。 CBT 组的 IE 评分和自我报告焦虑程度也较低 (p < .04)，IE 评分抑郁程度较低 (p < .01)，并且有较低自我报告抑郁程度的趋势 (p = .06)。在 ADHD 核心症状分析中统计控制抑郁水平时，CBT 继续显示出优于单独继续精神药理学的优势。与未接受 CBT 的患者 (13%) 相比，接受 CBT 的患者 (56%) 的治疗反应明显增多 (p < .02)。这些数据支持这样的假设：对于患有残留症状的 ADHD 成人来说，CBT 是一种可行、可接受且可能有效的下一步治疗方法，值得进一步测试。 (c) 2004 Elsevier Ltd. 保留所有权利。
The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms (p < .01) and global severity (p < .002), as well as self-reported ADHD symptoms (p < .0001) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety (p's < .04), lower IE-rated depression (p < .01), and a trend to have lower self-reported depression (p = .06). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) (p < .02). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing. (c) 2004 Elsevier Ltd. All rights reserved.