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20 Jan 2016

Jensen CM et al. Atten Defic Hyperact Disord 2016; 8: 3-11.

Cognitive behavioural therapy (CBT) could provide an effective intervention in the treatment of ADHD symptoms and functioning, results of a recent systematic literature review and meta-analysis suggest.

Researchers assessed the efficacy of CBT versus treatment as usual (TAU), considering the effects on ADHD symptoms as well as broader outcomes of anxiety, depression and global functioning.

Only two small studies of adults aged ≥18 years receiving ADHD medication fulfilled inclusion criteria.

Meta-analyses showed that although patient-reported ADHD symptoms* showed significant improvement with CBT compared with TAU (standardised mean difference [SMD] -1.0, 95% confidence interval [CI] -1.5–0.5), this was not observed when symptoms were independently evaluated by a clinician (SMD -0.6, 95% CI -1.3–0.1). However, global functioning, depression and anxiety‡§ – both patient-reported and/or independently evaluated – showed significant improvements with CBT compared with TAU.

The authors concluded that although the efficacy of CBT on core ADHD symptoms is not clear, improvements in functioning, anxiety and depression indicate that CBT may have a significant clinical effect through the formation of coping strategies (e.g. development of social, compensatory and communication skills). It should be noted that the overall quality of evidence from the two studies was considered low by GRADE assessment – partly due to small sample size.

More high-quality randomised studies are required to establish the benefits of CBT for ADHD symptoms and broader outcomes.

Read more about cognitive behavioural therapy in the treatment of ADHD here


*Barkley ADHD Symptom Scale/ADHD Current Symptom Scale
DuPaul Scale
Clinical Global Impression
§Beck Depression Inventory; Beck Anxiety Inventory; Hamilton Depression Scale; Hamilton Anxiety Scale

Jensen CM, Amdisen BL, Jørgensen KJ, et al. Cognitive behavioural therapy for ADHD in adults: systematic review and meta-analyses. Atten Defic Hyperact Disord 2016; 8: 3-11.

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