Non pharmacological interventions for adult ADHD: systematic review

Victoria Nimmo-Smith, Andrew Merwood, Dietmar Hank, Janet Brandling, Rosemary Greenwood, Lara Skinner, Sarah Law, Viran Patel, Dheeraj Rai

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Background
Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder, often persisting into adulthood. Whilst medication is first-line treatment for ADHD, there is a need for evidence-based non-pharmacological treatment options for adults with ADHD who are either still experiencing significant symptoms or for those who have made the informed choice not to start medication.

Methods
We systematically searched PsycINFO, MEDLINE (Ovid), EMBASE, CINAHL and CENTRAL for randomised controlled trials of non-pharmacological treatments for ADHD in adults. After screening of titles and abstracts, full text articles were reviewed, data extracted and bias assessed using a study proforma.

Results
There were 32 eligible studies with the largest number of studies assessing cognitive behavioural therapy (CBT). CBT consisted of either group, internet or individual therapy.

Conclusions
The majority found an improvement in ADHD symptoms with CBT treatment. Additionally, mindfulness and cognitive remediation have evidence as effective interventions for the core symptoms of ADHD and there is evidence for the use of group dialectical behavioural therapy and hypnotherapy. However, evidence for these is weaker due to small numbers of participants and limitations due to the lack of suitable control conditions, and a high risk of bias.
Original languageEnglish
Number of pages13
JournalPsychological Medicine
Early online date10 Feb 2020
DOIs
Publication statusE-pub ahead of print - 10 Feb 2020

Structured keywords

  • Physical and Mental Health

Keywords

  • ADHD
  • adults
  • non-pharmacological therapy
  • randomised controlled-trials
  • systematic review

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