Cognitive Behavioral Therapy May Be Better Than Medicine Alone in Treating Adult ADHD, Study Says
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Reviewed By Laura J. Martin, MD
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Aug. 24, 2010 -- Adults who take medicine for attention deficit hyperactivity disorder (ADHD) may benefit from adding cognitive behavioral therapy, a new study says. Doing so may yield better results than using medication alone.
Cognitive behavioral therapy appears to significantly reduce symptoms associated with ADHD, such as inattention, hyperactivity, and impulsivity, the researchers say.
They report that there is a need for alternative ways to treat ADHD because many adults either cannot or will not take medication or show a poor medication response.
Medication Plus Cognitive Behavioral Therapy
Cognitive behavioral therapy involves identifying negative or dysfunctional thoughts that affect a person's mood, sense of self, or behavior and replacing them with healthier ways of thinking.
Steven A. Safren, PhD, of the Massachusetts General Hospital in Boston, and colleagues tested cognitive behavioral therapy on 86 adults with ADHD. The patients had been treated with medications but still had symptoms.
Of those patients, 79 completed treatment and 70 finished follow-up assessments.
Patients were randomly put in 12 individual sessions of either cognitive behavioral therapy or relaxation in conjunction with educational support. Patients continued to take their medication as prescribed.
The cognitive behavioral therapy focused on organization skills and planning, skills to reduce distractibility, learning to think more adaptively in situations that cause distress, and prevention of relapse.
Participants in the relaxation group received training in progressive muscle relaxation and other relaxation techniques and education about ADHD and psychotherapy.
Symptoms of ADHD were rated by a trained assessor using accepted rating scales at the start of the trial, at the end of treatment, and at six-month and 12-month follow-ups.
Compared with the relaxation group, the cognitive behavior therapy group showed more improvement in ADHD symptoms. The improvements seen in the cognitive behavior group were maintained over six months and 12 months.
"This 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," the authors say. "Further study is required to examine whether this cognitive behavioral therapy intervention may be useful for individuals who may be unwilling or unable, for medical reasons, to take medication for ADHD."
The study is published in the Aug. 25 issue of the Journal of the American Medical Association.
SOURCES: News release, Journal of the American Medical Association.
Safren, S. Journal of the American Medical Association, Aug. 25, 2010, vol 304: pp 875-880.
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