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

Published online by Cambridge University Press:  28 February 2018

Lotte Janssen ,
Cornelis C. Kan ,
Pieter J. Carpentier ,
Bram Sizoo ,
Sevket Hepark ,
Melanie P.J. Schellekens ,
A. Rogier T. Donders ,
Jan K. Buitelaar  and
Anne E.M. Speckens
Lotte Janssen*
Affiliation:
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
Cornelis C. Kan
Affiliation:
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
Pieter J. Carpentier
Affiliation:
Reinier van Arkel, ‘s-Hertogenbosch, The Netherlands
Bram Sizoo
Affiliation:
Dimence, Deventer, The Netherlands
Sevket Hepark
Affiliation:
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
Melanie P.J. Schellekens
Affiliation:
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
A. Rogier T. Donders
Affiliation:
Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
Jan K. Buitelaar
Affiliation:
Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
Anne E.M. Speckens
Affiliation:
Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
*
Author for correspondence: Lotte Janssen, E-mail: [email protected]
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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 symptomsadult ADHDmental healthmindfulnessmindfulness-based cognitive therapypsychosocial treatmentrandomised controlled trial
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 1 , January 2019 , pp. 55 - 65
Copyright
Copyright © Cambridge University Press 2018 

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