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

doi:10.1017/S0033291720000069

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 journal › Article (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 language	English
Number of pages	13
Journal	Psychological Medicine
Early online date	10 Feb 2020
DOIs	https://doi.org/10.1017/S0033291720000069
Publication status	Published - 1 Mar 2020

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Research Groups and Themes

Physical and Mental Health

Keywords

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

Access to Document

10.1017/S0033291720000069

Full-text PDF (author’s accepted manuscript)
This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Cambridge University Press at https://www.cambridge.org/core/journals/psychological-medicine/article/nonpharmacological-interventions-for-adult-adhd-a-systematic-review/538F70FB89C5B687F4A75E7431E63B38 . Please refer to any applicable terms of use of the publisher.
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title = "Non pharmacological interventions for adult ADHD: systematic review",

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.",

keywords = "ADHD, adults, non-pharmacological therapy, randomised controlled-trials, systematic review",

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

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T1 - Non pharmacological interventions for adult ADHD: systematic review

AU - Nimmo-Smith, Victoria

AU - Merwood, Andrew

AU - Hank, Dietmar

AU - Brandling, Janet

AU - Greenwood, Rosemary

AU - Skinner, Lara

AU - Law, Sarah

AU - Patel, Viran

AU - Rai, Dheeraj

PY - 2020/3/1

Y1 - 2020/3/1

N2 - 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.

AB - 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.

KW - ADHD

KW - adults

KW - non-pharmacological therapy

KW - randomised controlled-trials

KW - systematic review

U2 - 10.1017/S0033291720000069

DO - 10.1017/S0033291720000069

M3 - Article (Academic Journal)

C2 - 32036811

SN - 0033-2917

JO - Psychological Medicine

JF - Psychological Medicine

ER -

Non pharmacological interventions for adult ADHD: systematic review

Abstract

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Keywords

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