Does brief, clinically based, intensive multimodal behavior therapy enhance the effects of methylphenidate in children with ADHD?

Eur Child Adolesc Psychiatry. 2007 Feb;16(1):48-57. doi: 10.1007/s00787-006-0574-z. Epub 2006 Sep 13.

Abstract

Objective: The additional value of a short-term, clinically based, intensive multimodal behavior therapy to optimally titrated methylphenidate in children with attention-deficit hyperactivity disorder (ADHD) was investigated.

Method: Fifty children with ADHD (ages 8-12) were randomized to treatment of methylphenidate or treatment with methylphenidate combined with 10 weeks of multimodal behavior therapy. The multimodal behavior therapy consisted of a child and parent behavioral therapy and a teacher behavioral training. Assessments included parent, teacher and child ratings of ADHD symptoms, oppositional and conduct behavior, social skills, parenting stress, anxiety and self-worth.

Results: Both treatment conditions yielded significant improvements on all outcome domains. No significant differences were found between both treatments.

Conclusions: No evidence was found for the additive effect of multimodal behavior therapy next to optimally titrated methylphenidate.

Clinical implications: This study does not support the expectation that optimally dosed stimulant treated children with ADHD should routinely receive psychosocial treatment to further reduce ADHD- and related symptoms.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenergic Uptake Inhibitors / therapeutic use
  • Adult
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Behavior Therapy*
  • Child
  • Cognition / physiology
  • Combined Modality Therapy
  • Double-Blind Method
  • Female
  • Humans
  • Intelligence
  • Male
  • Manuals as Topic
  • Mental Disorders / epidemiology
  • Methylphenidate / therapeutic use*
  • Parents / psychology
  • Wechsler Scales

Substances

  • Adrenergic Uptake Inhibitors
  • Methylphenidate