Psychological Treatment for Adults With Attention-Deficit/Hyperactivity Disorder (ADHD)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01659164
Recruitment Status : Completed
First Posted : August 7, 2012
Last Update Posted : April 3, 2015
Stockholm County Council, Sweden
Information provided by (Responsible Party):
Viktor Kaldo, Karolinska Institutet

Brief Summary:
The purpose of this uncontrolled pilot study is to develop and make an initial evaluation of a new treatment manual for treatment of ADHD in adults. The objectives in the treatment is to build relational skills, skills in organizing and structuring everyday life, handle difficult emotions and impulses etc. The treatment will be in a group format and it is hypothesized that the psychological intervention will result in reduced ADHD symptoms and to decreased experience of stress and depressive symptoms. The uncontrolled design does not allow for any causal inferences from the results, this pilot study is primarily to be seen as a preparation before a subsequent RCT.

Condition or disease Intervention/treatment Phase
ADHD Behavioral: Group treatment for adults with ADHD Not Applicable

Detailed Description:

Approximately one-third of children with ADHD continue to be fully symptomatic into adulthood and many of the remainders often retain some residual problems that require treatment. Thus ADHD is a prevalent and chronic disabling disorder. Drugs provide first line treatment for adults with ADHD but are not enough for everybody, while we still lack proper evidence for promising psychological treatment. In addition to core symptoms of ADHD including regulatory difficulties of attention, activity level and impulses, difficulties with emotional regulation are common.

Follow-up studies of adults with ADHD have shown that only a few patients were offered sufficient treatment and support after the neuropsychiatric assessment and testing. The majority of adults diagnosed with ADHD are offered pharmacological treatment (stimulant medication) as the sole treatment. However, stimulant medication is not effective for up to 20-50 percent of adults as they may not experience symptom reduction or they are unable to tolerate the medication.

Consequently, the possible benefits of identifying and treating individuals with ADHD are extensive. Treatment of ADHD is preferably multimodal, i.e. consisting of more than one intervention.

There has been limited research to date concerning psychosocial treatments for adult ADHD. Studies of cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) show that structured short-term therapies are promising in reducing ADHD related symptoms and increasing life quality. Focus in the CBT treatment is to build skills, increasing and compensating for deficits in the executive functioning due to impairments of the frontal lobe. DBT combines change-oriented skills from CBT with acceptance-oriented skills and core mindfulness skills. DBT skills have been tried out and validated as a promising intervention package for adults with ADHD through the research of Steven Safren and Bernd Hesslinger.

The objective of the planned study is to evaluate a new manual for group treatment, with a combination of treatment methods from Safrens and Hesslingers evidence-based treatment manuals. The aim of the pilot project is to create a clinically effective combination of the different methods of treatment, with a high degree of understanding, acceptance, use and perceived usefulness of the patients undergoing treatment. Both qualitative and quantitative data about patients' perceptions and use of the different methods will be collected during and after treatment to increase knowledge of how treatments can be developed and combined in order to better match the needs of patients.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 18 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Psychological Treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) - Pilot Evaluation of a New Treatment Manual Based on CBT and DBT
Study Start Date : August 2012
Actual Primary Completion Date : June 2014
Actual Study Completion Date : June 2014

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Group treatment (uncontrolled)
Psychological treatment in group for adults with ADHD (pilot) during 14 weeks with focus on decreasing disabilities due to the condition.
Behavioral: Group treatment for adults with ADHD
14 weeks of group treatment for adults with ADHD

Primary Outcome Measures :
  1. Change (from baseline) in ASRS- v 1.1 [ Time Frame: 14 weeks (post) ]
    ADHD Self Report Scale (self rating)

Secondary Outcome Measures :
  1. Change (from baseline) in ADHD Rating Scale [ Time Frame: 14 weeks (post) ]
    ADHD Rating Scale - assessed by a clinician

  2. Change (from baseline) in EQ-5D [ Time Frame: 14 weeks (post) ]
    Euroqol - (self report) to measure general health and quality of life

  3. Change (from baseline) in ISI [ Time Frame: 14 weeks (post) ]
    Insomnia Severity Index - (self report) to measure insomnia symptoms

  4. Change (from baseline) in PSS-4 [ Time Frame: 14 weeks (post) ]
    Perceived Stress Scale - (self report) to measure level of stress in everyday life

  5. Change (from baseline) in Sheehan Disability Scale [ Time Frame: 14 weeks (post) ]
    Sheehan Disability Scale - (self report) to measure level of disability in everyday life

  6. Change (from baseline) in MADRS-S [ Time Frame: 14 weeks (post) ]
    Montgomery-Åsberg Depression Rating Scale - (self report) to measure level of depression

  7. Change (from baseline) in DERS [ Time Frame: 14 weeks (post) ]
    Difficulties of Emotion Regulation Scale - (self report)

Other Outcome Measures:
  1. Treatment evaluation [ Time Frame: 14 weeks (post) ]
    The investigators design own questions in order to evaluate how the participants have experienced the intervention regarding to knowledge, usage of the treatment methods and possible difficulties that they have experienced during treatment. Our aim is to use these evaluations to evolve and improve the quality of the treatment manual.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. * Clinical diagnosis of AD/HD
  2. * Age 18-65
  3. 17 or more on the Adult ADHD Self Report Scale (ASRS v1.1)
  4. Not medically treated for adhd symptoms, or medically treated with central stimulants or comparable substance since at least one month with no significant changes in dosage and where no change in medical treatment is anticipated during the study time frame for the participant.
  5. No change in any other medical treatment is anticipated during the study time frame for the participant.
  6. Participant are by investigators considered able to follow through the training protocol and take part in measures taken during the study time frame
  7. The participant hasn´t used drugs the last 3 months.

    Exclusion Criteria:

  8. Diagnosed substance abuse according to DSM-IV criteria within 3 months prior to screening. Earlier episodic substance abuse is not excluding
  9. Co-existing psychiatric condition that investigators believe will unable the participant to follow through the training protocol and take part in measures taken during the study time frame.
  10. IQ ≤70 according to a neuropsychological assessment
  11. * Suicidality risk which is assessed during the first assessment interview.
  12. Organic brain syndrome
  13. Serious somatic condition which will unable the participant to participate (through the training protocol)or, is anticipated to have a negative impact on the treatment results
  14. Autism spectrum disorder (severe)
  15. Severe depression
  16. Other current psychological treatment for AD/HD

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01659164

Internetpsykiatrienheten, Psykiatri Sydväst, SLSO
Stockholm, Sweden
Sponsors and Collaborators
Karolinska Institutet
Stockholm County Council, Sweden
Principal Investigator: Viktor Kaldo, Ph.D. Karolinska Institutet

Responsible Party: Viktor Kaldo, Principal Investigator, Karolinska Institutet Identifier: NCT01659164     History of Changes
Other Study ID Numbers: 2012/333-31
First Posted: August 7, 2012    Key Record Dates
Last Update Posted: April 3, 2015
Last Verified: April 2015

Keywords provided by Viktor Kaldo, Karolinska Institutet:
Cognitive Behavioral Therapy
Dialectical Behavioral Therapy
Group Treatment

Additional relevant MeSH terms:
Attention Deficit Disorder with Hyperactivity
Attention Deficit and Disruptive Behavior Disorders
Neurodevelopmental Disorders
Mental Disorders