Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial
Abstract Background Studies on structured skills training groups have indicated beneficial, although still inconclusive, effects on core symptoms of ADHD in adults. This trial examined effects of Dialectical Behavioral Therapy-based group treatment (DBT-bGT) on the broader and clinically relevant ex...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-022-04356-6 |
| _version_ | 1811190239008391168 |
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| author | Anne Halmøy Anna Edith Ring Rolf Gjestad Merete Møller Bente Ubostad Tage Lien Ellen Kathrine Munkhaugen Mats Fredriksen |
| author_facet | Anne Halmøy Anna Edith Ring Rolf Gjestad Merete Møller Bente Ubostad Tage Lien Ellen Kathrine Munkhaugen Mats Fredriksen |
| author_sort | Anne Halmøy |
| collection | DOAJ |
| description | Abstract Background Studies on structured skills training groups have indicated beneficial, although still inconclusive, effects on core symptoms of ADHD in adults. This trial examined effects of Dialectical Behavioral Therapy-based group treatment (DBT-bGT) on the broader and clinically relevant executive functioning and emotional regulation in adults with ADHD. Methods In a multicenter randomized controlled trial, adult patients with ADHD were randomly assigned to receive either weekly DBT-bGT or treatment as usual (TAU) during 14 weeks. Subsequently, participants receiving TAU were offered DBT-bGT. All were reassessed six months after ended DBT-bGT. Primary outcomes were the Behavior Rating Inventory of Executive Function (BRIEF-A) and the Difficulties in Emotion Regulation Scale (DERS). Secondary outcomes included self-reported ADHD-symptoms, depressive and anxiety symptoms, and quality of life. We used independent samples t- tests to compare the mean difference of change from pre- to post-treatment between the two treatment groups, and univariate linear models adjusting for differences between sites. Results In total, 121 participants (68 females), mean age 37 years, from seven outpatient clinics were included, of whom 104 (86%) completed the 14-week trial. Entering the study, 63% used medication for ADHD. Compared to TAU (n = 54), patients initially completing DBT-bGT (n = 50) had a significantly larger mean reduction on the BRIEF-A (-12.8 versus -0.37, P = 0.005, effect size 0.64), and all secondary outcomes, except for symptoms of anxiety. All significant improvements persisted at 6 months follow-up. Change on DERS did not differ significantly between the groups after 14 weeks, but scores continued to decrease between end of group-treatment and follow-up. Conclusions This DBT-bGT was superior to TAU in reducing executive dysfunction, core symptoms of ADHD and in improving quality of life in adults with ADHD. Improvements sustained six months after ended treatment. The feasibility and results of this study provide evidence for this group treatment as a suitable non-pharmacological treatment option for adults with ADHD in ordinary clinical settings. Trial registrations The study was pre-registered in the ISRCTN registry (identification number ISRCTN30469893, date February 19th 2016) and at the ClinicalTrials.gov (ID: NCT02685254, date February 18th 2016). |
| first_indexed | 2024-04-11T14:47:55Z |
| format | Article |
| id | doaj.art-37300481d87243438d8cc69acfb60c60 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-11T14:47:55Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-37300481d87243438d8cc69acfb60c602022-12-22T04:17:34ZengBMCBMC Psychiatry1471-244X2022-11-0122111410.1186/s12888-022-04356-6Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trialAnne Halmøy0Anna Edith Ring1Rolf Gjestad2Merete Møller3Bente Ubostad4Tage Lien5Ellen Kathrine Munkhaugen6Mats Fredriksen7Division of Psychiatry, Kronstad District Psychiatric Center, Haukeland University HospitalDivision of Psychiatry, Research Department, Haukeland University HospitalDivision of Psychiatry, Research Department, Haukeland University HospitalDistrict Psychiatric Center, Østfold Hospital TrustRegional Resource Center for Autism, AD/HD, and Tourettes Syndrome, Western Norway Regional Health Authority, Haukeland University HospitalRegional Resource Center for Autism, AD/HD, and Tourettes Syndrome, South-Eastern Norway Regional Health Authority, Oslo University HospitalRegional Resource Center for Autism, AD/HD, and Tourettes Syndrome, South-Eastern Norway Regional Health Authority, Oslo University HospitalDivision of Mental Health & Addiction, Vestfold Hospital TrustAbstract Background Studies on structured skills training groups have indicated beneficial, although still inconclusive, effects on core symptoms of ADHD in adults. This trial examined effects of Dialectical Behavioral Therapy-based group treatment (DBT-bGT) on the broader and clinically relevant executive functioning and emotional regulation in adults with ADHD. Methods In a multicenter randomized controlled trial, adult patients with ADHD were randomly assigned to receive either weekly DBT-bGT or treatment as usual (TAU) during 14 weeks. Subsequently, participants receiving TAU were offered DBT-bGT. All were reassessed six months after ended DBT-bGT. Primary outcomes were the Behavior Rating Inventory of Executive Function (BRIEF-A) and the Difficulties in Emotion Regulation Scale (DERS). Secondary outcomes included self-reported ADHD-symptoms, depressive and anxiety symptoms, and quality of life. We used independent samples t- tests to compare the mean difference of change from pre- to post-treatment between the two treatment groups, and univariate linear models adjusting for differences between sites. Results In total, 121 participants (68 females), mean age 37 years, from seven outpatient clinics were included, of whom 104 (86%) completed the 14-week trial. Entering the study, 63% used medication for ADHD. Compared to TAU (n = 54), patients initially completing DBT-bGT (n = 50) had a significantly larger mean reduction on the BRIEF-A (-12.8 versus -0.37, P = 0.005, effect size 0.64), and all secondary outcomes, except for symptoms of anxiety. All significant improvements persisted at 6 months follow-up. Change on DERS did not differ significantly between the groups after 14 weeks, but scores continued to decrease between end of group-treatment and follow-up. Conclusions This DBT-bGT was superior to TAU in reducing executive dysfunction, core symptoms of ADHD and in improving quality of life in adults with ADHD. Improvements sustained six months after ended treatment. The feasibility and results of this study provide evidence for this group treatment as a suitable non-pharmacological treatment option for adults with ADHD in ordinary clinical settings. Trial registrations The study was pre-registered in the ISRCTN registry (identification number ISRCTN30469893, date February 19th 2016) and at the ClinicalTrials.gov (ID: NCT02685254, date February 18th 2016).https://doi.org/10.1186/s12888-022-04356-6Attention-deficitHyperactivity disorder (ADHD)AdultsNon-pharmacological treatmentGroup therapyDialectical behavioral therapy (DBT) |
| spellingShingle | Anne Halmøy Anna Edith Ring Rolf Gjestad Merete Møller Bente Ubostad Tage Lien Ellen Kathrine Munkhaugen Mats Fredriksen Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial BMC Psychiatry Attention-deficit Hyperactivity disorder (ADHD) Adults Non-pharmacological treatment Group therapy Dialectical behavioral therapy (DBT) |
| title | Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial |
| title_full | Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial |
| title_fullStr | Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial |
| title_full_unstemmed | Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial |
| title_short | Dialectical behavioral therapy-based group treatment versus treatment as usual for adults with attention-deficit hyperactivity disorder: a multicenter randomized controlled trial |
| title_sort | dialectical behavioral therapy based group treatment versus treatment as usual for adults with attention deficit hyperactivity disorder a multicenter randomized controlled trial |
| topic | Attention-deficit Hyperactivity disorder (ADHD) Adults Non-pharmacological treatment Group therapy Dialectical behavioral therapy (DBT) |
| url | https://doi.org/10.1186/s12888-022-04356-6 |
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