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

Lotte Janssen; Cornelis C Kan; Pieter J Carpentier; Bram Sizoo; Sevket Hepark; Melanie P J Schellekens; A Rogier T Donders; Jan K Buitelaar; Anne E M Speckens

doi:10.1017/S0033291718000429

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

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

Authors

Lotte Janssen¹, Cornelis C Kan¹, Pieter J Carpentier², Bram Sizoo³, Sevket Hepark¹, Melanie P J Schellekens¹, A Rogier T Donders⁴, Jan K Buitelaar⁵, Anne E M Speckens¹

Affiliations

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.

PMID: 29486807
DOI: 10.1017/S0033291718000429

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.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity / therapy*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mindfulness / methods*
Outcome Assessment, Health Care*
Psychotherapy, Group / methods*
Single-Blind Method

Associated data

ClinicalTrials.gov/NCT02463396