Question: In adults with ADHD, what is the evidence that psychotherapy (including individual and group CBT, psychoeducation, psychosocial interventions) when compared to any other intervention (including medication, medication plus psychotherapy, no treatment) improves patient outcomes, including reduction in inattentive, hyperactive and impulsive symptoms, improvement in co-morbid symptoms such as anxiety, depression or anger, reduction or withdrawal from medication, and improving well-being or quality of life?

Answer:

No definite clinical implications can be made from the available evidence due to a lack of studies with a low risk of bias. There is a trend, however, that cognitive behavioural group therapies in both medicated, or mixed medicated/non-medicated participants, appear to be effective in comparison to medication alone, or other control treatments. The included studies suggest that clinicians should make an effort to offer patients this type of treatment, or that CBT for adults is a useful next strategy for patients who show continued symptoms despite treatment with medication.

Recommendations in the literature for further research are that studies should be larger, long-term, and should evaluate measures other than core ADHD symptoms, such as comorbid disorders, quality of life, and functional impairment. In addition, it was suggested that future studies should examine the effectiveness of CBT in individuals who may be unwilling or unable, for medical reasons, to take medication for ADHD - and to determine the relative efficacy of pharmacotherapy and psychosocial treatments, separately and together, for the treatment of ADHD. Future studies may also need to investigate whether different patients or settings may be more receptive or conducive to an individual versus a group therapy approach.