Top

ADHD Attention Deficit and Hyperactivity Disorders

Published in:

01-12-2010 | Original Article

Evaluation of the efficacy and effectiveness of a structured disorder tailored psychotherapy in ADHD in adults: study protocol of a randomized controlled multicentre trial

Authors: Alexandra Philipsen, Erika Graf, Ludger Tebartz van Elst, Thomas Jans, Andreas Warnke, Bernd Hesslinger, Dieter Ebert, Manfred Gerlach, Swantje Matthies, Michael Colla, Christian Jacob, Esther Sobanski, Barbara Alm, Michael Rösler, Gabriele Ihorst, Silke Gross-Lesch, Laura Gentschow, Bernhard Kis, Michael Huss, Klaus Lieb, Michael Schlander, Mathias Berger

Published in: ADHD Attention Deficit and Hyperactivity Disorders | Issue 4/2010

Abstract

ADHD is a serious risk factor for co-occurring psychiatric disorders and negative psychosocial consequences in adulthood. Previous trials on psychotherapeutic concepts for adult ADHD are based on behavioural (cognitive behavioural and dialectical behavioural) psychotherapeutic approaches and showed significant effects. The aim of our study group (COMPAS) is to carry out a first randomized and controlled multicentre study to evaluate the effects of a disorder tailored psychotherapy in adult ADHD compared to clinical management in combination with psychopharmacological treatment or placebo. A total of 448 adults with ADHD according to DSM-IV will be treated at seven university sites in Germany. In a four-arm design, patients are randomized to a manualized dialectical behavioural therapy (DBT) based group programme plus methylphenidate or placebo or clinical management plus methylphenidate or placebo with weekly sessions in the first 12 weeks and monthly sessions thereafter. Therapists are graduated psychologists or physicians. Treatment integrity is established by independent supervision. Primary endpoint (ADHD symptoms measured by the Conners Adult Rating Scale) is rated by interviewers blind to the treatment allocation. Intention-to-treat analysis will be performed within a linear regression model (Current Controlled Trials ISRCTN54096201). The trial is funded by the German Federal Ministry of Research and Education (01GV0606) and is part of the German network for the treatment of ADHD in children and adults (ADHD-NET).

Available only for authorised users

Beck AT, Ward CH, Mendelson M, Mock H, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed

Biederman J (2004) Impact of comorbidity in adults with attention-deficit/hyperactivity disorder. J Clin Psychiatry 65 (Suppl 3): 3–7 (review)

Birnbaum HG, Kessler RC, Lowe SW et al (2005) Costs of attention deficit-hyperactivity disorder (ADHD) in the US: excess costs of persons with ADHD and their family members in 2000. Curr Med Res Opin 21(2):195–206CrossRefPubMed

Bramham J, Young S, Bickerdike A, Spain D, McCartan D, Xenitidis K (2009) Evaluation of Group Cognitive Behavioral Therapy for Adults With ADHD. J Atten Disord 12(5):434–441CrossRefPubMed

Brazier J, Roberts J, Deverill M (2002) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21:271–292CrossRefPubMed

Christiansen H, Kis B, Hirsch O, Philipsen A, Henneck M, Panczuk A, Pietrowsky R, Hebebrand J, Schimmelmann BG (2010) German validation of the Conners Adult ADHD Rating Scales-self-report (CAARS-S) I: Factor structure and normative data. Eur Psychiatry

Conners CK, Ehrhard D, Sparrow D (1999) CAARS adult ADHD rating scales. MHS, New York

Derogatis LR (1977) SCL-90-R: administration, scoring and procedures manual II. Clinical Psychometric Research, Towson, MD

Ebert D, Krause J, Roth-Sackenheim C (2003) ADHS im erwachsenenalter–leitlinien auf der basis eines expertkonsensus mit unterstutzung der DGPPN. Nervenarzt 74:939–946PubMed

Endicott J, Nee J, Harrison W, Blumenthal R (1993) Quality of life enjoyment and satisfaction questionnaire: a new measure. Psychopharmacol Bull 29(2):321–326PubMed

Faraone SV, Spencer T, Aleardi M et al (2004) Meta-analysis of the efficacy of methylphenidate for treating adult attention-deficit/hyperactivity disorder. J Clin Psychopharm 24:24–29CrossRef

Franke GH (2002) SCL-90-R. Die symptom-checkliste von derogatis–deutsche version. Beltz, Weinheim

Guy W (1976). ECDEU Assessment manual for psychopharmacology

Hesslinger B, Tebartz van Elst L, Nyberg E et al (2002) Psychotherapy of attention deficit hyperactivity disorder in adults - A pilot study using a structured skills training program. Eur Arch Psychiatry Clin Neurosci 252:177–184PubMed

Hesslinger B, Philipsen A, Richter H (2003) Psychotherapy in adult ADHD. Verhaltenstherapie 13:276–282CrossRef

Hesslinger B, Philipsen A, Richter H et al (2004) Psychotherapie der ADHS im Erwachsenenalter–ein Arbeitsbuch. Hogrefe, Goettigen

Jacob CP, Philipsen A, Ebert D et al (2008) Multimodale therapie der aufmerksamkeitsdefizit-/hyperaktivitaetsstoerung im erwachsenenalter. Nervenarzt 79:801–808CrossRefPubMed

Knapp M, Mangalore R (2007) The trouble with QALYs. Epidemiol Psychiatr Soc 26:289–293

Lehrl S (1977) Mehrfachwahl-Wortschatz-Intelligenztest Form B. Straube, Erlangen

Linehan MM (1993) Cognitive-behavioral treatment of borderline personality disorder. Guildford Press, New York

Mannuzza S, Klein G, Bessler A et al (1998) Adult psychiatric status of hyperactive boys grown up. Am J Psychiatry 155:493–498PubMed

Matza LS (2007) Responsiveness of the adult attention-deficit/hyperactivity disorder quality of life scale (AAQoL). Qual Life Res 16:1511–1520CrossRefPubMed

Medori R, Ramos-Quiroga JA, Casas M et al (2008) A randomized, placebo-controlled trial of three fixed dosages of prolonged-release OROS methylphenidate in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry 63(10):981–989CrossRefPubMed

Mick E, Faraone SV, Spencer T, Zhang HF, Biederman J (2008) Assessing the validity of the quality of life enjoyment and satisfaction questionnaire short form in adults with ADHD. J Atten Disord 11(4):504–509CrossRefPubMed

Philipsen A (2006) Differential diagnosis and comorbidity of attentiondeficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults. Eur Arch Psychiatr Clin Neurosci 256(Suppl 1):i42–i46CrossRef

Philipsen A, Richter H, Peters J et al (2007) Structured group psychotherapy in adults with attention deficit hyperactivity disorder: results of an open multicenter study. J Nerv Ment Dis 195:1013–1019CrossRefPubMed

Philipsen A, Limberger MF, Lieb K et al (2008) Attention deficit/hyperactivity disorder as a potentially aggravating factor in borderline personality disorder. Br J Psychiatry 192:118–123CrossRefPubMed

Philipsen A, Feige B, Hesslinger B et al (2009) Borderline typical symptoms in adult patients with attention deficit/hyperactivity disorder. ADHD Atten Defic Hyperact Disord 1:11–18CrossRef

Retz-Junginger P, Retz W, Blocher D et al (2002) Wender utah rating scale (WURS-k). Nervenarzt 73:830–838CrossRefPubMed

Retz-Junginger P, Retz W, Blocher D et al (2003) Reliabilitaet und Validitaet der Wender-Utah-Rating-Scale Kurzform. Retrospektive Erfassung von Symptomen aus dem Spektrum der Aufmerksamkeitsdefizit/Hyperaktivitaetsstoerung. Nervenarzt 74:987–993CrossRefPubMed

Roesler M, Retz W, Retz-Junginger P et al (2004) Instrumente zur diagnostik der aufmerksamkeitsdefizit-/hyperaktivitaetsstoerung (ADHS) im Erwachsenenalter. Selbstbeurteilungsskala (ADHS-SB) und Diagnosecheckliste (ADHS-DC). Nervenarzt 75:888–895

Rösler M, Retz W, Stieglitz RD (2010) Psychopathological rating scales as efficacy parameters in adult ADHD treatment investigations–benchmarking instruments for international multicentre trials. Pharmacopsychiatry 43(3):92–98CrossRefPubMed

Safren SA, Otto MW, Sprich STE et al (2005) Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther 43:831–842CrossRefPubMed

Salakari A, Virta M, Grönroos N et al (2010) Cognitive-behaviorally-oriented group rehabilitation of adults with ADHD: results of a 6-month follow-up. J Atten Disord 13(5):516–523CrossRefPubMed

Schlander M (2007) Health technology assessments by the national institute for health and clinical excellence. A qualitative study. Springer, New York

Schlander M, Trott GE, Schwarz O (2010). The health economics of attention deficit hyperactivity disorder in Germany. Part 1: Health care utilization and cost of illness. Nervenarzt 81(3): 289–300 (review German)

Schmitz N, Hartkamp N, Kiuse J et al (2000) The symptom check-list-90-R (SCL-90-R): a German validation study. Qual Life Res 9(2):185–193CrossRefPubMed

Secnik K, Swensen A, Lage MJ (2005) Comorbidities and costs of adult patients diagnosed with attention-deficit hyperactivity disorder. Pharmacoeconomics 23(1):93–102CrossRefPubMed

Solanto MV, Marks DJ, Wasserstein J et al (2010) Efficacy of meta-cognitive therapy for adult ADHD. Am J Psychiatry 167(8):958–968CrossRefPubMed

Stevenson CS, Whitmont S, Bornholt L et al (2002) A cognitive remediation programme for adults with attention deficit hyperactivity disorder. Austr New Z J Psychiatr 36:610–616CrossRef

Virta M, Vedenpää A, Grönroos N et al (2008) Adults with ADHD benefit from cognitive-behaviorally oriented group rehabilitation: a study of 29 participants. J Atten Disord 12(3):218–226CrossRefPubMed

Wender PH, Wolf LE, Wasserstein J (2001) Adults with ADHD: an overview. Ann NY Acad Sci 931:1–16CrossRefPubMed

Wilens TE, Faraone SV, Biederman J (2004) Attention deficit/hyperactivity disorder in adults. JAMA 292(5):619–623CrossRefPubMed

Wittchen HU, Zaudig M, Fydrich T (1997) SKID–strukturiertes klinisches interview fuer DSM IV. Achse I und II. Hogrefe, Goettingen

Zylowska L, Ackerman DL, Yang MH et al (2008) Mindfulness meditation training in adults and adolescents with ADHD: a feasibility study. J Atten Disord 11(6):737–746CrossRefPubMed

Title: Evaluation of the efficacy and effectiveness of a structured disorder tailored psychotherapy in ADHD in adults: study protocol of a randomized controlled multicentre trial
Authors: Alexandra Philipsen
Erika Graf
Ludger Tebartz van Elst
Thomas Jans
Andreas Warnke
Bernd Hesslinger
Dieter Ebert
Manfred Gerlach
Swantje Matthies
Michael Colla
Christian Jacob
Esther Sobanski
Barbara Alm
Michael Rösler
Gabriele Ihorst
Silke Gross-Lesch
Laura Gentschow
Bernhard Kis
Michael Huss
Klaus Lieb
Michael Schlander
Mathias Berger
Publication date: 01-12-2010
Publisher: Springer Vienna
Published in: ADHD Attention Deficit and Hyperactivity Disorders / Issue 4/2010
Print ISSN: 1866-6116
Electronic ISSN: 1866-6647
DOI: https://doi.org/10.1007/s12402-010-0046-7

At a glance: The STEP trials

Springer Medicine

Evaluation of the efficacy and effectiveness of a structured disorder tailored psychotherapy in ADHD in adults: study protocol of a randomized controlled multicentre trial

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2010

Neurobiological and psychophysiological correlates of emotional dysregulation in ADHD patients

The history of attention deficit hyperactivity disorder

The quality of life of children and adolescents with ADHD undergoing outpatient psychiatric treatment: simple disorders of activity and attention and hyperkinetic conduct disorders in comparison with each other and with other diagnostic groups

To Andreas Warnke, Professor of Child and Adolescent Psychiatry, Head of the Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy at the University of Wuerzburg, Germany, to celebrate his professional life and work at the occasion of his 65th anniversary

Association of ADHD with reactive and proactive violent behavior in a forensic population

Inflammation: good or bad for ADHD?