A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)-A Randomized Controlled Trial
A Comparison of Cognitive-Behavioral Therapy and Pharmacotherapy vs. Pharmacotherapy Alone in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)-A Randomized Controlled Trial
复制标题
DOI：
10.3389/fpsyt.2018.00571
复制
发表时间：
2018-11-16
影响因子：
4.7
通讯作者：
Stieglitz, Rolf-Dieter
中科院分区：
文献类型：
--
作者：
Corbisiero, Salvatore;Bitto, Hannes;Stieglitz, Rolf-Dieter
在成人注意力缺陷多动障碍（ADHD）的治疗中，心理干预与药物治疗相结合的重要性在当代临床常规中被广泛接受。这种疾病的自然病程似乎证明了额外的心理干预是合理的，因为即使在高度依从药物治疗的患者中，也不总是能完全缓解。本研究的目的是分析心理治疗对成人ADHD患者治疗的贡献。在一项随机对照研究中，将心理治疗与药物治疗联合治疗的疗效与单独药物干预进行了比较。在开始哌甲酯（MPH）治疗并使其稳定后，对所有受试者进行两种不同治疗条件的随机化。之后，两组都接受了大约10-12周的治疗，实验组接受认知行为治疗（CBT），而对照组只接受药物和标准临床管理（SCM）。ADHD症状在时间上有统计学差异，但在两种不同的治疗条件下没有统计学差异。这一结果对于注意力不集中、多动、冲动和情感障碍等单一ADHD患者和障碍患者都是一样的。个体标准化ADHD特定CBT程序无法优于SCM。
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.