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There is a high need for evidence-based psychosocial treatments for adult attention-deficit hyperactivity disorder (ADHD) to offer alongside treatment as usual (TAU). Mindfulness-based cognitive therapy (MBCT) is a promising psychosocial treatment. This trial investigated the efficacy of MBCT + TAU v. TAU in reducing core symptoms in adults with ADHD.
A multicentre, single-blind, randomised controlled trial (ClinicalTrials.gov: NCT02463396). Participants were randomly assigned to MBCT + TAU (n = 60), an 8-weekly group therapy including meditation exercises, psychoeducation and group discussions, or TAU only (n = 60), which reflected usual treatment in the Netherlands and included pharmacotherapy and/or psychoeducation. Primary outcome was ADHD symptoms rated by blinded clinicians. Secondary outcomes included self-reported ADHD symptoms, executive functioning, mindfulness skills, self-compassion, positive mental health and general functioning. Outcomes were assessed at baseline, post-treatment, 3- and 6-month follow-up. Post-treatment effects at group and individual level, and follow-up effects were examined.
In MBCT + TAU patients, a significant reduction of clinician-rated ADHD symptoms was found at post-treatment [M difference = −3.44 (−5.75, −1.11), p = 0.004, d = 0.41]. This effect was maintained until 6-month follow-up. More MBCT + TAU (27%) than TAU participants (4%) showed a ⩽30% reduction of ADHD symptoms (p = 0.001). MBCT + TAU patients compared with TAU patients also reported significant improvements in ADHD symptoms, mindfulness skills, self-compassion and positive mental health at post-treatment, which were maintained until 6-month follow-up. Although patients in MBCT + TAU compared with TAU reported no improvement in executive functioning at post-treatment, they did report improvement at 6-month follow-up.
MBCT might be a valuable treatment option alongside TAU for adult ADHD aimed at alleviating symptoms.
Although the phenomenon of ADHD (Attention-Deficit Hyperactivity Disorder) is well described in children, it is now thought that in up to 60% of cases the symptoms persist into adulthood. This volume reviews our growing knowledge of adult ADHD and presents a transatlantic perspective on the identification, assessment and treatment of the disorder. The introductory section covers the history of ADHD, as well as the epidemiology, consequences, gender differences and legal aspects. Detailed descriptions of the clinical features of ADHD in adults are then given to enhance the reader's clinical recognition and assessment. Subsequent sections cover treatment strategies, emphasising pharmacological, psychological and social interventions. Written and edited by experts internationally renowned for their work in ADHD, this is an essential resource for all mental health workers who encounter adults presenting with neurodevelopmental disorders.