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BMC Psychiatry
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Study protocol

Mindfulness based cognitive therapy versus treatment as usual in adults with attention deficit hyperactivity disorder (ADHD)

Authors: Lotte Janssen, Cornelis C. Kan, Pieter J. Carpentier, Bram Sizoo, Sevket Hepark, Janneke Grutters, Rogier Donders, Jan K. Buitelaar, Anne E M Speckens

Published in: BMC Psychiatry | Issue 1/2015

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Abstract

Background

Adults with attention deficit hyperactivity disorder (ADHD) often present with a lifelong pattern of core symptoms that is associated with impairments of functioning in daily life. This has a substantial personal and economic impact. In clinical practice there is a high need for additional or alternative interventions for existing treatments, usually consisting of pharmacotherapy and/or psycho-education. Although previous studies show preliminary evidence for the effectiveness of mindfulness-based interventions in reducing ADHD symptoms and improving executive functioning, these studies have methodological limitations. This study will take account of these limitations and will examine the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) in further detail.

Methods/design

A multi-centre, parallel-group, randomised controlled trial will be conducted in N = 120 adults with ADHD. Patients will be randomised to MBCT in addition to treatment as usual (TAU) or TAU alone. Assessments will take place at baseline and at three, six and nine months after baseline. Primary outcome measure will be severity of ADHD symptoms rated by a blinded clinician. Secondary outcome measures will be self-reported ADHD symptoms, executive functioning, mindfulness skills, self-compassion, positive mental health and general functioning. In addition, a cost-effectiveness analysis will be conducted.

Discussion

This trial will offer valuable information about the clinical and cost-effectiveness of MBCT in addition to TAU compared to TAU alone in adults swith ADHD.

Trial registration

ClinicalTrials.gov NCT02463396. Registered 8 June 2015.
Literature
1.
Simon V, Czobor P, Balint S, Meszaros A, Bitter I. Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry. 2009;194(3):204–11.CrossRefPubMed
2.
Tuithof M, Ten Have M, van Dorsselaer S, de Graaf R. Prevalence, persistency and consequences of ADHD in the Dutch adult population. Tijdschrift Psychiatrie. 2014;1(56):10–9.
3.
Dalsgaard S, Ostergaard SD, Leckman JF, Mortensen PB, Pedersen MG. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet. 2015;385(9983):2190–6.CrossRefPubMed
4.
Küpper T, Haavik J, Drexler H, Ramos-Quiroga JA, Wermelskirchen D, Prutz C, et al. The negative impact of attention-deficit/hyperactivity disorder on occupational health in adults and adolescents. Int Arch Occup Environ Health. 2012;85(8):837–47.CrossRefPubMed
5.
de Graaf R, Kessler RC, Fayyad J, ten Have M, Alonso J, Angermeyer M, et al. The prevalence and effects of adult attention-deficit/hyperactivity disorder (ADHD) on the performance of workers: results from the WHO World Mental Health Survey Initiative. Occup Environ Med. 2008;65(12):835–42.CrossRefPubMedPubMedCentral
6.
Fayyad J, De Graaf R, Kessler R, Alonso J, Angermeyer M, Demyttenaere K, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190:402–9.CrossRefPubMed
7.
National Institute for Clinical Excellence. Attention deficit hyperactivity disorder: the NICE guideline on diagnosis and management of ADHD in children, young people and adults. London: The British Psychological Society and the Royal College of Psychiatrists; 2009.
8.
Meszaros A, Czobor P, Balint S, Komlosi S, Simon V, Bitter I. Pharmacotherapy of adult attention deficit hyperactivity disorder (ADHD): a meta-analysis. Int J Neuropsychopharmacol. 2009;12(8):1137–47.CrossRefPubMed
9.
Wigal T, Brams M, Gasior M, Gao J, Squires L, Giblin J et al. Randomized, double-blind, placebo-controlled, crossover study of the efficacy and safety of lisdexamfetamine dimesylate in adults with attention-deficit/hyperactivity disorder: novel findings using a simulated adult workplace environment design. Behavioral and Brain Functions. 2010;6(1):34.
10.
Lichtenstein P, Halldner L, Zetterqvist J, Sjölander A, Serlachius E, Fazel S, et al. Medication for attention deficit–hyperactivity disorder and criminality. N Engl J Med. 2012;367(21):2006–14.
11.
Chen Q, Sjölander A, Runeson B, D’Onofrio BM, Lichtenstein P, Larsson H. Drug treatment for attention-deficit/hyperactivity disorder and suicidal behaviour: register based study. BMJ: Br Med J. 2014;348.
12.
Wigal SB. Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults. CNS Drugs. 2009;23(1):21–31.CrossRefPubMed
13.
Biederman J, Mick E, Surman C, Doyle R, Hammerness P, Harpold T, et al. A randomized, placebo-controlled trial of OROS methylphenidate in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2006;59(9):829–35.CrossRefPubMed
14.
Perwien AR, Hall J, Swensen A, Swindle R. Stimulant treatment patterns and compliance in children and adults with newly treated attention-deficit/hyperactivity disorder. J Manag Care Pharm. 2004;10(2):122–9.PubMed
15.
Fredriksen M, Halmøy A, Faraone SV, Haavik J. Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: A review of controlled and naturalistic studies. Eur Neuropsychopharmacol. 2013;23(6):508–27.CrossRefPubMed
16.
Mongia M, Hechtman L. Cognitive behavior therapy for adults with attention-deficit/hyperactivity disorder: a review of recent randomized controlled trials. Curr Psychiatry Rep. 2012;14(5):561–7.CrossRefPubMed
17.
Safren SA, Otto MW, Sprich S, Winett CL, Wilens TE, Biederman J. Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther. 2005;43(7):831–42.CrossRefPubMed
18.
Solanto MV, Marks DJ, Wasserstein J, Mitchell K, Abikoff H, Alvir JMJ, et al. Efficacy of Meta-Cognitive Therapy for Adult ADHD. Am J Psychiat. 2010;167(8):958–68.CrossRefPubMedPubMedCentral
19.
Kabat-Zinn J, Hanh TN. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Random House Publishing Group; 2009.
20.
Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression. New York: Guilford Press; 2012.
21.
Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, et al. Mindfulness-based therapy: A comprehensive meta-analysis. Clin Psychol Rev. 2013;33(6):763–71.CrossRefPubMed
22.
Strauss C, Cavanagh K, Oliver A, Pettman D. Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials. PLoS ONE. 2014;9(4):13.CrossRef
23.
Tang Y-Y, Holzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci. 2015;16(4):213–25.CrossRefPubMed
24.
Malinowski P. Neural mechanisms of attentional control in mindfulness meditation. Front Neurosci. 2013;7.
25.
Fox KC, Nijeboer S, Dixon ML, Floman JL, Ellamil M, Rumak SP, et al. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev. 2014;43:48–73.CrossRefPubMed
26.
Chiesa A, Calati R, Serretti A. Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clin Psychol Rev. 2011;31(3):449–64.CrossRefPubMed
27.
Zylowska L, Ackerman DL, Yang MH, Futrell JL, Horton NL, Hale TS, et al. Mindfulness Meditation Training in Adults and Adolescents With ADHD A Feasibility Study. J Atten Disord. 2008;11(6):737–46.CrossRefPubMed
28.
Hepark S, Kan CC, Speckens A. Toepasbaarheid en effectiviteit van mindfulnesstraining bij volwassenen met AD(H)D; een open pilotonderzoek. Tijdschr Psychiatr. 2014;56(7):471–6.PubMed
29.
Mitchell JT, McIntyre EM, English JS, Dennis MF, Beckham JC, Kollins SH. A pilot trial of mindfulness meditation training for ADHD in adulthood: impact on core symptoms, executive functioning, and emotion dysregulation. Journal of attention disorders. 2013:1087054713513328.
30.
Zylowska L, Smalley SL, Schwartz JM. Mindful awareness and ADHD. Clinical handbook of mindfulness. New York: Springer; 2009.
31.
32.
Kooij JJS, Francken MH. Diagnostisch interview voor ADHD (DIVA) bij volwassenen. 2007.
33.
Van Vliet I, De Beurs E, Het Mini Internationaal Neuropsychiatrisch Interview (MINI). Een kort gestructureerd diagnostisch psychiatrisch interview voor DSM-IV en ICD-10-stoornissen [The Mini International Neuropsychiatric Interview (MINI). A short structured diagnostic psychiatric interview for DSM-IV and ICD-10 disorders]. Tijdschr Psychiatr. 2007;49(6):393–7.PubMed
34.
First MB, Spitzer RL, Gibbon M, Williams JBW. The structured interview for DSM-III-R personality-disorders (SCID-II).1. Description. J Pers Disord. 1995;9(2):83–91.CrossRef
35.
Conners CK, Erhardt D, Sparrow E. CAARS adult ADHD rating scales. Technical Manual. Toronto, Ontario, Canada: Multi-Health Systems; 1999.
36.
Adler LA, Faraone SV, Spencer TJ, Michelson D, Reimherr FW, Glatt SJ, et al. The Reliability and Validity of Self- and Investigator Ratings of ADHD in Adults. J Atten Disord. 2008;11(6):711–9.CrossRefPubMed
37.
Roth RM, Isquith PK, Gioia GA. BRIEF-A: Behavior Rating Inventory of Executive Function - Adults Version. Psychological Assessment Resources. 2005.
38.
Scholte E, Noens I. BRIEF-A: Vragenlijst over executief functioneren bij volwassenen. Hogrefe; 2011.
39.
Bohlmeijer E, ten Klooster PM, Fledderus M, Veehof M, Baer R. Psychometric Properties of the Five Facet Mindfulness Questionnaire in Depressed Adults and Development of a Short Form. Assessment. 2011;18(3):308–20.CrossRefPubMed
40.
Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13(1):27–45.CrossRefPubMed
41.
Raes F, Pommier E, Neff KD, Van Gucht D. Construction and Factorial Validation of a Short Form of the Self-Compassion Scale. Clin Psychol Psychother. 2011;18(3):250–5.CrossRefPubMed
42.
Neff KD. The development and validation of a scale to measure self-compassion. Self Identity. 2003;2(3):223–50.CrossRef
43.
Lamers SMA, Westerhof GJ, Bohlmeijer ET, ten Klooster PM, Keyes CLM. Evaluating the Psychometric Properties of the Mental Health Continuum-Short Form (MHC-SF). J Clin Psychol. 2011;67(1):99–110.CrossRefPubMed
44.
Keyes CLM. The mental health continuum: From languishing to flourishing in life. J Health Soc Behav. 2002;43(2):207–22.CrossRefPubMed
45.
Lambert MJ, Burlingame GM, Umphress V, Hansen NB, Vermeersch DA, Clouse GC, et al. The Reliability and Validity of the Outcome Questionnaire. Clin Psychol Psychother. 1996;3(4):249–58.CrossRef
46.
de Jong K, Nugter MA, Polak MG, Wagenborg JEA, Spinhoven P, Heiser WJ. The Outcome Questionnaire (OQ-45) in a Dutch population: A cross-cultural validation. Clin Psychol Psychother. 2007;14(4):288–301.CrossRef
47.
Hakkaart-van Roijen L, van Straten A, Donker M, Tiemens B. Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P). Rotterdam: Institute for Medical Technology Assessment; 2002.
48.
Bouwmans C, Jong KD, Timman R, Zijlstra-Vlasveld M, Van der Feltz-Cornelis C, Tan SS, et al. Feasibility, reliability and validity of a questionnaire on healthcare consumption and productivity loss in patients with a psychiatric disorder (TiC-P). BMC Health Serv Res. 2013;13.
49.
Ware JE, Kosinski M, Keller SD. A 12-item short-form health survey - Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.CrossRefPubMed
50.
McHorney CA, Ware JE, The RAE, MOS. 36-item Short-Form Health Survey (SF-36).2. Psychometric and clinical-tests of validity in measuring physical and mental-health constructs. Med Care. 1993;31(3):247–63.CrossRefPubMed
51.
Lim LLY, Fisher JD. Use of the 12-item Short-Form (SF-12) Health Survey in an Australian heart and stroke population. Qual Life Res. 1999;8(1–2):1–8.CrossRefPubMed
52.
Crane RS, Kuyken W, Williams JMG, Hastings RP, Cooper L, Fennell MJV. Competence in Teaching Mindfulness-Based Courses: Concepts, Development and Assessment. Mindfulness. 2012;3(1):76–84.CrossRefPubMed
53.
Hakkaart-van Roijen L, Tan SS, Bouwmans CAM. Handleiding voor kostenonderzoek: Methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg; Erasmus Universiteit Rotterdam: College voor zorgverzekeringen; 2010.
54.
Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91.CrossRefPubMed
Metadata
Title
Mindfulness based cognitive therapy versus treatment as usual in adults with attention deficit hyperactivity disorder (ADHD)
Authors
Lotte Janssen
Cornelis C. Kan
Pieter J. Carpentier
Bram Sizoo
Sevket Hepark
Janneke Grutters
Rogier Donders
Jan K. Buitelaar
Anne E M Speckens
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0591-x

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