Group therapy for adolescents with attention-deficit/hyperactivity disorder: a randomized controlled trial

Raquel Vidal; Jordi Castells; Vanesa Richarte; Gloria Palomar; Marta García; Rosa Nicolau; Luisa Lazaro; Miguel Casas; Josep Antoni Ramos-Quiroga

doi:10.1016/j.jaac.2014.12.016

Group therapy for adolescents with attention-deficit/hyperactivity disorder: a randomized controlled trial

J Am Acad Child Adolesc Psychiatry. 2015 Apr;54(4):275-82. doi: 10.1016/j.jaac.2014.12.016. Epub 2015 Jan 26.

Authors

Raquel Vidal¹, Jordi Castells², Vanesa Richarte³, Gloria Palomar³, Marta García², Rosa Nicolau², Luisa Lazaro⁴, Miguel Casas¹, Josep Antoni Ramos-Quiroga⁵

Affiliations

¹ Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona.
² Hospital Clínic of Barcelona.
³ Hospital Universitari Vall d'Hebron, ADHD Program, Barcelona, Spain.
⁴ Hospital Clinic of Barcelona, (CIBERSAM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and with the University of Barcelona.
⁵ Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona. Electronic address: jaramos@vhebron.net.

PMID: 25791144
DOI: 10.1016/j.jaac.2014.12.016

Abstract

Objective: To determine the efficacy of group cognitive-behavioral therapy (CBT) on adolescents with attention-deficit/hyperactivity disorder (ADHD) who were in pharmacological treatment but still had persistent symptoms.

Method: We conducted a multicenter, randomized, rater-blinded, controlled trial between April 2012 and May 2014 in a cohort of 119 adolescents (15-21 years of age). Participants were randomly assigned to 12 manualized group CBT sessions (n = 45) or a waiting list control group (n = 44). Primary outcomes were assessed by a blinded evaluator (ADHD Rating Scale [ADHD-RS], Clinical Global Impression Scale for Severity [CGI-S], Global Assessment of Functioning [GAF]) before and after treatment, as well as by self-report and parent informant ratings.

Results: Of the initial 119 participants enrolled, 89 completed treatment. A mixed-effects model analysis revealed that participants who were assigned to the group CBT sessions experienced significantly reduced ADHD symptoms compared to the control group (ADHD-RS Adolescent: -7.46, 95% CI = -9.56 to -5.36, p < .001, d = 7.5; ADHD-RS Parents: -9.11, 95% CI = -11.48 to -6.75, p < .001, d = 8.38; CGI-S Self-Report: -0.68, 95% CI = -0.98 to -0.39, p < .001, d = 3.75; CGI-S Clinician: -0.79, 95% CI = -0.95 to -0.62, p < .001; d = 7.71). Functional impairment decreased significantly in the CBT group according to parents (Weiss Functional Impairment Scale -4.02, 95% CI = -7.76 to -0.29, p < .05, d = 2.29) and according to the blinded evaluator (GAF: -7.58, 95% CI = -9.1 to -6.05, p < .001, d = 7.51).

Conclusion: Group CBT associated with pharmacological treatment is an efficacious intervention for reducing ADHD symptoms and functional impairment in adolescents. Clinical trial registration information-CBT Group for Adolescents With ADHD: a Randomized Controlled Trial; http://clinicaltrials.gov/; NCT02172183.

Keywords: ADHD; cognitive-behavioral therapy; group therapy; psychological treatment.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Attention Deficit Disorder with Hyperactivity / diagnosis
Attention Deficit Disorder with Hyperactivity / therapy*
Cognitive Behavioral Therapy / methods*
Female
Humans
Male
Psychiatric Status Rating Scales
Psychotherapy, Group / methods*
Self Report
Severity of Illness Index
Single-Blind Method
Spain
Treatment Outcome
Young Adult

Associated data

ClinicalTrials.gov/NCT02172183