Attention Deficit Disorder With Hyperactivity Clinical Trial
Official title:
Short Structured Psychological Intervention for Adults With ADHD - a Randomized Controlled Trial
The purpose of this study is to evaluate the effects of a novel psychological intervention for adult ADHD through a randomized controlled trial. Participants will be randomized to receive either a face-to-face manualized short psychological intervention, SAINT, or corresponding self-help material with limited access to therapist support. The main objective is to evaluate whether SAINT will show better outcomes on measures of ADHD-related symptoms, everyday function, and quality-of-life measures, when compared to the self-help material, and if any possible differences in outcomes are related to better treatment adherence in SAINT.
ADHD is associated with deficiencies in short-term memory and executive function, negatively
affecting patients' abilities to organize, schedule, multitask, follow through on
instructions and finish jobs. This leads to uneven performance and possibly chronic
underperformance in relation to actual intellectual resources. Psychiatric comorbidity is
common for patients with ADHD, with 70-80% of adult patients meeting the criteria for at
least one more clinical diagnosis. ADHD is also associated with sensation seeking and
reckless behavior, including substance use and criminal activity.
Despite an increase in demand for assessment and treatment of ADHD among adults, access to
evidence-based treatment is limited. In Sweden, most adult patients with ADHD are only
offered pharmacological treatment. Pharmacological treatment, while in many cases effective,
does not meet the demands of all patients, with 20-50% of patients not experiencing enough
initial effect and/or excessive side-effects. Pharmacological treatment of ADHD also shows
problems with long-term adherence, with approximately half of patients terminating treatment
within the first two years, regardless of initial effect. Research on psychological treatment
for adult ADHD is limited, though studies on behavioral treatment, including short-term
therapies based on cognitive behavior therapy (CBT) and dialectic behavior therapy (DBT),
have shown promising results.
This project, dubbed Short ADHD Intervention (SAINT), is based on previous research and
pilot-studies of psychological treatments for adult ADHD. An existing treatment manual, based
on CBT and DBT practices, will be fitted into a five-session, intensive face-to-face
behavioral intervention, with a booster session at a one-month follow-up. The intervention
will be compared to an equally long, active comparative control, consisting of self-help
material and limited therapist support via Internet. Approximately 80 participants will be
recruited at outpatient clinics in Stockholm. The participants will be randomized to receive
either SAINT or the self-help material and limited therapist support.
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