Abstract
BackgroundAdults with attention deficit hyperactivity disorder (ADHD) often present with a lifelong pattern of core symptoms that is associated with impairments of functioning in daily life. This has a substantial personal and economic impact. In clinical practice there is a high need for additional or alternative interventions for existing treatments, usually consisting of pharmacotherapy and/or psycho-education. Although previous studies show preliminary evidence for the effectiveness of mindfulness-based interventions in reducing ADHD symptoms and improving executive functioning, these studies have methodological limitations. This study will take account of these limitations and will examine the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) in further detail.Methods/designA multi-centre, parallel-group, randomised controlled trial will be conducted in N = 120 adults with ADHD. Patients will be randomised to MBCT in addition to treatment as usual (TAU) or TAU alone. Assessments will take place at baseline and at three, six and nine months after baseline. Primary outcome measure will be severity of ADHD symptoms rated by a blinded clinician. Secondary outcome measures will be self-reported ADHD symptoms, executive functioning, mindfulness skills, self-compassion, positive mental health and general functioning. In addition, a cost-effectiveness analysis will be conducted.DiscussionThis trial will offer valuable information about the clinical and cost-effectiveness of MBCT in addition to TAU compared to TAU alone in adults swith ADHD.Trial registrationClinicalTrials.gov NCT02463396. Registered 8 June 2015.
Highlights
Adults with attention deficit hyperactivity disorder (ADHD) often present with a lifelong pattern of core symptoms that is associated with impairments of functioning in daily life
This trial will offer valuable information about the clinical and cost-effectiveness of Mindfulness Based Cognitive Therapy (MBCT) in addition to treatment as usual (TAU) compared to TAU alone in adults swith ADHD
Sample size The power calculation has been based on our previous randomised controlled study consisting of 103 adults with ADHD (Hepark et al, submitted) in which we demonstrated a significant difference in post-assessment clinician-rated ADHD symptoms (CAARS-INV) [36] between the MBCT and waitlist control group
Summary
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder with a high persistence into adulthood. Another promising psychosocial intervention for patients with ADHD is Mindfulness-Based Cognitive Therapy (MBCT), which combines methods of CBT and mindfulness meditation. There is evidence that mindfulness meditation strengthens attention regulation [23,24,25] and improves some executive functions [26] in healthy subjects These studies were not focused on patients with ADHD and replication studies need to be carried out, this is promising evidence in the search for an effective nonpharmacological treatment for this patient group. The results of the above mentioned studies support the feasibility and efficacy of mindfulness training as a treatment for adults with ADHD and encourage further research. In order to gain insight in the working mechanisms of mindfulness, we will investigate whether possible clinical effects of MBCT can be attributed to changes in mindfulness skills, self-compassion and adherence to MBCT
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