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: | , , , , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
July 2022
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| 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 
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| 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 |
MARC
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| 245 | 1 | 0 | |a Multimodal treatment efficacy differs in dependence of core symptom profiles in adult Attention-Deficit/Hyperactivity Disorder |b an analysis of the randomized controlled COMPAS trial |c 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 |
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| 520 | |a 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. | ||
| 650 | 4 | |a ADHD subtype presentations | |
| 650 | 4 | |a Adults | |
| 650 | 4 | |a Attention-deficit/hyperactivity disorder | |
| 650 | 4 | |a Core symptoms | |
| 650 | 4 | |a Methylphenidate | |
| 650 | 4 | |a Psychotherapy | |
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| 700 | 1 | |a Mayr, Andreas |e VerfasserIn |4 aut | |
| 700 | 1 | |a Philipsen, Alexandra |e VerfasserIn |4 aut | |
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