Efficacy of Cognitive Behavioral Therapy Combined with Pharmacotherapy Versus Pharmacotherapy Alone in Adult ADHD: A Systematic Review and Meta-Analysis

J Atten Disord. 2024 Feb;28(3):279-292. doi: 10.1177/10870547231214969. Epub 2023 Dec 12.

Abstract

Background: ADHD diagnosis rates are rising; however, currently, no effective treatment method that has been identified. This study compared the efficacy of CBT + M with M for adult ADHD.

Methods: PubMed, Embase, WOS, and Cochrane Library databases were searched up to July 29, 2023. Literature screening and data analysis were conducted.

Results: The six randomized controlled studies included. Meta-analysis showed that CBT + M was more effective than M in improving ADHD symptoms. Subgroup analysis showed developed countries significant in ADHD symptoms improvement. At the 3-month, CBT + M was superior to M, but at the 6 and 9 months, no statistically significant differences were observed.

Conclusion: CBT + M is more effective than M in improving adult ADHD symptoms and maintains an advantage for at least 3 months. It is recommended to intensifying CBT treatment after 3 months. Country and economy may influence results. Combined therapy for ADHD should be prioritized in developed countries.

Keywords: ADHD; adult; cognitive behavioral therapy; meta-analysis; pharmacotherapy.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Attention Deficit Disorder with Hyperactivity* / psychology
  • Cognitive Behavioral Therapy* / methods
  • Humans
  • Treatment Outcome
  • Waiting Lists