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Multimodal treatment efficacy differs in dependence of core symptom profiles in adult Attention-Deficit/Hyperactivity Disorder: an analysis of the randomized controlled COMPAS trial

There is broad consensus that to improve the treatment of adult Attention-Deficit/Hyperactivity Disorder (ADHD), the various therapy options need to be tailored more precisely to the individual patient's needs and specific symptoms. This post-hoc analysis evaluates the multimodal effects of fir...

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Hauptverfasser: Selaskowski, Benjamin (VerfasserIn) , Staerk, Christian (VerfasserIn) , Braun, Niclas (VerfasserIn) , Matthies, Swantje (VerfasserIn) , Graf, Erika (VerfasserIn) , Colla, Michael (VerfasserIn) , Jacob, Christian (VerfasserIn) , Sobanski, Esther (VerfasserIn) , Alm, Barbara (VerfasserIn) , Roesler, Michael (VerfasserIn) , Retz, Wolfgang (VerfasserIn) , Retz-Junginger, Petra (VerfasserIn) , Kis, Bernhard (VerfasserIn) , Abdel-Hamid, Mona (VerfasserIn) , Huss, Michael (VerfasserIn) , Jans, Thomas (VerfasserIn) , Tebartz van Elst, Ludger (VerfasserIn) , Berger, Mathias (VerfasserIn) , Lux, Silke (VerfasserIn) , Mayr, Andreas (VerfasserIn) , Philipsen, Alexandra (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: July 2022
In: Journal of psychiatric research
Year: 2022, Jahrgang: 151, Pages: 225-234
ISSN:1879-1379
DOI:10.1016/j.jpsychires.2022.03.049
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jpsychires.2022.03.049
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0022395622001789
Volltext
Verfasserangaben:Benjamin Selaskowski, Christian Staerk, Niclas Braun, Swantje Matthies, Erika Graf, Michael Colla, Christian Jacob, Esther Sobanski, Barbara Alm, Michael Roesler, Wolfgang Retz, Petra Retz-Junginger, Bernhard Kis, Mona Abdel-Hamid, Michael Huss, Thomas Jans, Ludger Tebartz van Elst, Mathias Berger, Silke Lux, Andreas Mayr, Alexandra Philipsen
Beschreibung
Zusammenfassung:There is broad consensus that to improve the treatment of adult Attention-Deficit/Hyperactivity Disorder (ADHD), the various therapy options need to be tailored more precisely to the individual patient's needs and specific symptoms. This post-hoc analysis evaluates the multimodal effects of first-line medication (methylphenidate [MPH] vs placebo [PLB]) and psychotherapeutic (group psychotherapy [GPT] vs clinical management [CM]) treatments on the ADHD core symptoms inattention, hyperactivity and impulsivity. For the two-by-two factorial, observer-blinded, multicenter, randomized controlled Comparison of Methylphenidate and Psychotherapy in Adult ADHD Study (COMPAS; ISRCTN54096201), 419 outpatients with ADHD were considered for analysis. ADHD symptoms were assessed by blind observer-rated and patient-rated Conners Adult ADHD Rating Scales before treatment (T1), 13 weeks (T2) and 26 weeks (T3) after T1, at treatment completion after 52 weeks (T4), and at follow-up (130 weeks, T5). MPH was superior to PLB in improving symptoms of inattention at almost all endpoints (observer-rated T2, T3, T4, T5; patient-rated T2, T3, T4), while a significant decrease in hyperactivity and impulsivity was at first found after 6 months of treatment. CM compared to GPT decreased inattention and impulsivity in the early treatment phase only (observer-rated T2, patient-rated T2, T3). In conclusion, while MPH seems to have a direct and sustained effect on inattention, premature medication discontinuation should particularly be avoided in patients with hyperactive-impulsive symptoms. Also, especially in high inattention and/or impulsivity presentations, initial individual patient management might be beneficial. Consequently, considering individual core symptom profiles may enhance the efficacy of treatments in adult ADHD.
Beschreibung:Online verfügbar: 1 April 2022, Artikelversion: 29 April 2022
Gesehen am 12.12.2023
Beschreibung:Online Resource
ISSN:1879-1379
DOI:10.1016/j.jpsychires.2022.03.049

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