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Non-pharmacological interventions for adult ADHD: a systematic review

Published online by Cambridge University Press:  10 February 2020

Victoria Nimmo-Smith Open the ORCID record for Victoria Nimmo-Smith [Opens in a new window] ,
Andrew Merwood ,
Dietmar Hank ,
Janet Brandling ,
Rosemary Greenwood ,
Lara Skinner ,
Sarah Law ,
Viran Patel  and
Dheeraj Rai Open the ORCID record for Dheeraj Rai [Opens in a new window]
Victoria Nimmo-Smith*
Affiliation:
Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
Andrew Merwood
Affiliation:
Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
Dietmar Hank
Affiliation:
Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
Janet Brandling
Affiliation:
University of the West of England, Bristol, UK
Rosemary Greenwood
Affiliation:
Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
Lara Skinner
Affiliation:
Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
Sarah Law
Affiliation:
Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
Viran Patel
Affiliation:
The Wellbeing Partnership CIC, Bristol, UK
Dheeraj Rai
Affiliation:
Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
*
Author for correspondence: Victoria Nimmo-Smith, E-mail: victoria.nimmo-smith@bristol.ac.uk
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Abstract

Background

Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder, often persisting into adulthood. Whilst medication is first-line treatment for ADHD, there is a need for evidence-based non-pharmacological treatment options for adults with ADHD who are either still experiencing significant symptoms or for those who have made the informed choice not to start medication.

Methods

We systematically searched PsycINFO, MEDLINE (Ovid), EMBASE, CINAHL and CENTRAL for randomised controlled trials of non-pharmacological treatments for ADHD in adults. After screening of titles and abstracts, full text articles were reviewed, data extracted and bias assessed using a study proforma.

Results

There were 32 eligible studies with the largest number of studies assessing cognitive behavioural therapy (CBT). CBT consisted of either group, internet or individual therapy.

Conclusions

The majority found an improvement in ADHD symptoms with CBT treatment. Additionally, mindfulness and cognitive remediation have evidence as effective interventions for the core symptoms of ADHD and there is evidence for the use of group dialectical behavioural therapy and hypnotherapy. However, evidence for these is weaker due to small numbers of participants and limitations due to the lack of suitable control conditions, and a high risk of bias.

Keywords

ADHDadultsnon-pharmacological therapyrandomised controlled-trialssystematic review
Type
Review Article
Information
Psychological Medicine , Volume 50 , Issue 4 , March 2020 , pp. 529 - 541
Copyright
Copyright © Cambridge University Press 2020

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Footnotes

*

Victoria Nimmo Smith and Andrew Merwood are joint first authors.

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