Psychological treatment of attention deficit hyperactivity disorder in adults: a systematic review.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood onset. The disorder persists into adulthood in most cases, significantly affecting patient function. Although the firstline choice of treatment for ADHD is pharmacological, drug treatments are not always sufficient. All the published studies on the psychological treatment of ADHD were systematically reviewed for the present article. METHOD: The MEDLINE and PsychINFO electronic databases were searched using the terms psychological treatment OR psychotherapy OR psychosocial treatment AND ADHD. Patient age was restricted to adults (all adult:19+ years). RESULTS: Eighteen published studies met inclusion criteria for the review. Fifteen efficacy studies of psychological treatment were selected (cognitive behavioral therapy, metacognitive therapy, dialectical behavior therapy, coaching, cognitive remediation) and three previous reviews. CONCLUSIONS: The results indicate that cognitive behavioral therapy is the most effective psychological treatment for ADHD symptoms in adults and the comorbid symptoms of anxiety and depression, which have an important functional impact on the daily life of patients. However, more research is needed to know the differential effects of each psychological approach in relation to improved ADHD symptoms in adults. Finally, future directions for the psychosocial treatment of ADHD problems of adults are suggested.

[Differential personality features in adult ADHD subtypes]. / Variables diferenciales de personalidad en los subtipos de TDAH en la edad adulta.

Attention Deficit/Hyperactivity Disorder (ADHD) and personality traits are relatively stable from childhood and across life span. The purpose of this study was to identify differential and discriminative personality traits between clinical subtypes of ADHD in adults. The Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) and the Millon Multiaxial Clinical Inventory-II (MCMI-II) were administered to a sample of 146 adults with ADHD. Activity and Aggression-Hostility dimensions from the ZKPQ allowed us to properly classify 75.8% of the inattentive and combined subtypes. Data indicates that ADHD is not a homogeneous entity, but rather, there are significant differences in personality characteristics among clinical subtypes. The results have theoretical implications about the connection between ADHD and personality, and clinical implications regarding diagnosis and treatment designs better tailored to the characteristics of each subtype.

Tratamiento psicológico del trastorno por déficit de atención con hiperactividad en adultos: revisión sistemática / Psychological treatment of attention deficit hyperactivity disorder in adults: a systematic review

Introducción. El trastorno por déficit de atención con hiperactividad (TDAH) es un trastorno del neurodesarrollo de inicio en la infancia y que en la mayoría de los casos persiste en la edad adulta afectando significativamente el funcionamiento del paciente. Aunque el tratamiento farmacológico se considere el tratamiento de primera elección para el TDAH en adultos, los tratamientos farmacológicos no siempre son suficientes. El objetivo de este artículo es revisar sistemáticamente todos los estudios publicados hasta el momento sobre el tratamiento psicológico del TDAH en adultos. Método. El método utilizado fue una búsqueda bibliográfica en las bases de datos MEDLINE y Psych INFO usando los términos psychological treatment OR psychotherapy OR psychosocial treatment AND ADHD. Se limitó la edad, seleccionando los tratamientos de adultos (all adult: 19+ years). Resultados. Cumplieron los criterios de inclusión 18 estudios publicados. Se seleccionaron 15 estudios de eficacia de tratamientos psicológicos (terapia cognitivo-conductual, terapia metacognitiva, terapia dialéctico, conductual, coachingy estudios de rehabilitación cognitiva) y 3 revisiones previas. Conclusiones. Los resultados indican que la terapia cognitivo-conductual es el abordaje más eficaz de tratamiento psicológico del TDAH en adultos y de la sintomatología comórbida de ansiedad y depresión; síntomas que también tienen una importante repercusión funcional en la vida diaria del paciente. No obstante, se requiere mayor investigación para conocer los efectos diferenciales de los distintos abordajes psicológicos en relación a las mejoras de la sintomatología del TDAH en adultos. Finalmente, se sugieren direcciones futuras para los estudios de tratamiento psicológico (AU)

Introduction. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood onset. The disorder persists into adulthood in most cases, significantly affecting patient function. Although the firstline choice of treatment for ADHD is pharmacological, drug treatments are not always sufficient. All the published studies on the psychological treatment of ADHD were systematically reviewed for the present article. Method. The MEDLINE and Psych INFO electronic databases were searched using the terms psychological treatment OR psychotherapy OR psychosocial treatment AND ADHD. Patient age was restricted to adults (all adult: 19+years). Results. Eighteen published studies met inclusion criteria for the review. Fifteen efficacy studies of psychological treatment were selected (cognitive behavioral therapy, metacognitive therapy, dialectical behavior therapy, coaching, cognitive remediation) and three previous reviews. Conclusions. The results indicate that cognitive behavioral therapy is the most effective psychological treatment for ADHD symptoms in adults and the comorbid symptoms of anxiety and depression, which have an important functional impact on the daily life of patients. However, more research is needed to know the differential effects of each psychological approach in relation to improved ADHD symptoms in adults. Finally, future directions for the psychosocial treatment of ADHD problems of adults are suggested (AU)

Variables diferenciales de personalidad en los subtipos de TDAH en la edad adulta / Differential personality features in adult ADHD subtypes

Los síntomas del trastorno por déficit de atención con hiperactividad (TDAH) y los rasgos de personalidad se manifiestan de forma relativamente estable y duradera desde la infancia y persisten a lo largo de la vida. El objetivo de este estudio consiste en identificar los rasgos de personalidad diferenciales y discriminativos entre los subtipos clínicos de TDAH en adultos. Se evaluaron las características de personalidad, mediante el Cuestionario de Personalidad de Zuckerman-Kuhlman (ZKPQ) y el Inventario Clínico Multiaxial de Millon-II (MCMI-II), en una muestra de 146 adultos diagnosticados de TDAH. Las dimensiones Activity y Aggression-Hostility del ZKPQ, permitieron clasificar correctamente al 75,8% de los diagnosticados en los subtipos inatento y combinado. Los resultados indican que el TDAH no es una entidad homogénea, sino que existen diferencias significativas en las características de personalidad entre los subtipos clínicos. Se discuten las implicaciones teóricas sobre la conexión entre TDAH y personalidad, y las implicaciones clínicas respecto al diagnóstico y diseño de tratamientos mejor ajustados a las características de cada subtipo(AU)

Attention Deficit/Hyperactivity Disorder (ADHD) and personality traits are relatively stable from childhood and across life span. The purpose of this study was to identify differential and discriminative personality traits between clinical subtypes of ADHD in adults. The Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) and the Millon Multiaxial Clinical Inventory-II (MCMI-II) were administered to a sample of 146 adults with ADHD. Activity and Aggression-Hostility dimensions from the ZKPQ allowed us to properly classify 75.8% of the inattentive and combined subtypes. Data indicates that ADHD is not a homogeneous entity, but rather, there are significant differences in personality characteristics among clinical subtypes. The results have theoretical implications about the connection between ADHD and personality, and clinical implications regarding diagnosis and treatment designs better tailored to the characteristics of each subtype(AU)