Evidence map›Paper›PMID 26022103›Full record

Trial reportPsychological medicine2015

Cognitive-behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: a randomized controlled trial using multi-level analysis.

S Young, M Khondoker, B Emilsson, J F Sigurdsson, F Philipp-Wiegmann, G Baldursson, H Olafsdottir, G Gudjonsson

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psychological medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
  3. Pooled it
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  8. A randomized controlled trial of cognitive behavioral therapy for ADHD in medication-treated adolescents.Journal of child psychology and psychiatry, and allied disciplines · 2016
    Trial
  9. Article
  10. Review
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  15. Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2018
    Review
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  19. The South African Society of Psychiatrists/Psychiatry Management Group management guidelines for adult attention-deficit/hyperactivity disorder.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2017
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

S YoungDivision of Brain Sciences,Department of Medicine,Centre for Mental Health,Imperial College London,London,UK.
M KhondokerKing's College London,Institute of Psychiatry,Psychology and Neuroscience,London,UK.
B EmilssonKing's College London,Institute of Psychiatry,Psychology and Neuroscience,London,UK.
J F SigurdssonReykjavik University,Reykjavik,Iceland.
F Philipp-WiegmannBroadmoor Hospital,West London Mental Health NHS Trust,Crowthorne,UK.
G BaldurssonLandspitali - The National University Hospital of Iceland,Reykjavik,Iceland.
H OlafsdottirLandspitali - The National University Hospital of Iceland,Reykjavik,Iceland.
G GudjonssonBroadmoor Hospital,West London Mental Health NHS Trust,Crowthorne,UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by high rates of co-morbid psychopathology. Randomized controlled trials of multimodal interventions, combining pharmacological and psychological treatments, have shown a robust treatment effect for ADHD symptoms but outcomes for co-morbid symptoms have been mixed. This may be accounted for by the type of intervention selected and/or by methodological problems including lack of follow-up and low power. The current study addressed these limitations in a parallel-group randomized controlled trial conducted in Iceland.

methodA total of 95 adult ADHD patients who were already being treated with medication (MED) were randomly assigned to receive treatment as usual (TAU/MED) or 15 sessions of cognitive-behavioural therapy (CBT/MED) using the R&R2ADHD intervention which employs both group and individual modalities. Primary measures of ADHD symptoms and severity of illness, and secondary measures of anxiety, depression and quality of life were given at baseline, end of treatment and 3-month follow-up. Primary outcomes were rated by clinicians blind to treatment condition assignment.

resultsCBT/MED showed overall (combined outcome at end of treatment and 3-month follow-up) significantly greater reduction in primary outcomes for clinician-rated and self-rated ADHD symptoms. Treatment effect of primary outcomes was maintained at follow-up, which suggests robust and lasting findings. In contrast to the primary outcomes, the secondary outcomes showed significant improvement over time.

conclusionsThe study provides evidence for the effectiveness of R&R2ADHD and demonstrates that there are differential effects over time for ADHD symptoms versus co-morbid problems, the latter taking longer to show positive effects.

Indexed as

AdultAnxietyAttention Deficit Disorder with HyperactivityCognitionCognitive Behavioral TherapyComorbidityDepressionDextroamphetamineDopamine Uptake InhibitorsFemaleHumansIcelandMaleMiddle AgedPsychiatric Status Rating ScalesQuality of LifeDextroamphetamineDopamine Uptake InhibitorsAttention-deficit/hyperactivity disordercognitive–behavioural therapyrandomized controlled trialsreasoning and rehabilitationR & R2treatment

Identifiers

PMID26022103
PMCPMC4595859

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.