Article Most Likely to Change Clinical Practice - Week Ending September 3, 2010

Individual CBT Associated with Sustained Improvement in ADHD Symptoms in Adults Taking Medication

Medications are often used for treatment for adults with attention deficit hyperactivity disorder (ADHD), but many patients remain symptomatic despite treatment with stimulants or other drugs. A recent randomized trial evaluated the efficacy of cognitive behavioral therapy (CBT) in 86 adult patients with persistent, clinically significant ADHD symptoms who were already being treated with medication. Patients were randomized to 12 weekly sessions of individual CBT vs. progressive muscle relaxation training with educational support. Medications were continued during the trial. In post-treatment assessment at approximately 15 weeks, the CBT group had a higher rate of treatment response on the Clinical Global Impressions scale (53% vs. 23%, p = 0.01, NNT 4) and on the ADHD rating scale (67% vs. 33%, p = 0.002, NNT 3) (level 2 [mid-level] evidence). CBT was also associated with significantly greater improvement in self-reported symptoms (p < 0.001). Responders in the CBT group showed sustained improvement at 6 and 12 month follow-up visits (JAMA 2010 Aug 25;304(8):875).

For more information, see the Attention-deficit hyperactivity disorder (ADHD) in adults topic in DynaMed.