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Psychol Med. 2019 Jan;49(1):55-65. doi: 10.1017/S0033291718000429. Epub 2018 Feb 28.

Mindfulness-based cognitive therapy v. treatment as usual in adults with ADHD: a multicentre, single-blind, randomised controlled trial.

Author information

1
Department of Psychiatry,Radboud University Medical Centre,Nijmegen,The Netherlands.
2
Reinier van Arkel,'s-Hertogenbosch,The Netherlands.
3
Dimence,Deventer,The Netherlands.
4
Department for Health Evidence,Radboud University Medical Centre,Nijmegen,The Netherlands.
5
Department of Cognitive Neuroscience,Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre,Nijmegen,The Netherlands.

Abstract

BACKGROUND:

There is a high need for evidence-based psychosocial treatments for adult attention-deficit hyperactivity disorder (ADHD) to offer alongside treatment as usual (TAU). Mindfulness-based cognitive therapy (MBCT) is a promising psychosocial treatment. This trial investigated the efficacy of MBCT + TAU v. TAU in reducing core symptoms in adults with ADHD.

METHODS:

A multicentre, single-blind, randomised controlled trial (ClinicalTrials.gov: NCT02463396). Participants were randomly assigned to MBCT + TAU (n = 60), an 8-weekly group therapy including meditation exercises, psychoeducation and group discussions, or TAU only (n = 60), which reflected usual treatment in the Netherlands and included pharmacotherapy and/or psychoeducation. Primary outcome was ADHD symptoms rated by blinded clinicians. Secondary outcomes included self-reported ADHD symptoms, executive functioning, mindfulness skills, self-compassion, positive mental health and general functioning. Outcomes were assessed at baseline, post-treatment, 3- and 6-month follow-up. Post-treatment effects at group and individual level, and follow-up effects were examined.

RESULTS:

In MBCT + TAU patients, a significant reduction of clinician-rated ADHD symptoms was found at post-treatment [M difference = -3.44 (-5.75, -1.11), p = 0.004, d = 0.41]. This effect was maintained until 6-month follow-up. More MBCT + TAU (27%) than TAU participants (4%) showed a ⩽30% reduction of ADHD symptoms (p = 0.001). MBCT + TAU patients compared with TAU patients also reported significant improvements in ADHD symptoms, mindfulness skills, self-compassion and positive mental health at post-treatment, which were maintained until 6-month follow-up. Although patients in MBCT + TAU compared with TAU reported no improvement in executive functioning at post-treatment, they did report improvement at 6-month follow-up.

CONCLUSIONS:

MBCT might be a valuable treatment option alongside TAU for adult ADHD aimed at alleviating symptoms.

KEYWORDS:

ADHD symptoms; adult ADHD; mental health; mindfulness; mindfulness-based cognitive therapy; psychosocial treatment; randomised controlled trial

PMID:
29486807
DOI:
10.1017/S0033291718000429

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