Formulation-Based CBT Improves Symptoms, Functioning in Adults With ADHD

Individual formulation-based cognitive behavioral therapy (CBT) with usual treatment is more effective than usual treatment alone for improving core symptoms, functioning, and emotional distress in adults with attention-deficit/hyperactivity disorder (ADHD), according to data published in Acta Psychiatrica Scandinavica.

Researchers from King’s College London, United Kingdom, conducted a randomized controlled trial to investigate the efficacy, patient acceptability, and feasibility of formulation-based CBT for adults with ADHD. The investigators randomly assigned 60 participants to receive usual treatment alone or up to 16 sessions of formulation-based CBT in addition to usual treatment.

Participants who received CBT showed improved ADHD symptoms at 42 weeks on the Barkley Current Symptoms Scale compared with participants who received usual treatment alone (P <.001). In addition, participants who received CBT also had improved scores on the Work and Social Adjustment Scale compared with those who received usual treatment alone (P =.003).

The results also showed that CBT provided significantly greater improvements for self-rated anxiety and global distress and resulted in improved measures on the Clinical Global Impression scales.

The researchers note several limitations, including a high number of participants in the usual treatment group who were lost to follow-up. The study also did not control for therapist time and attention, and the authors note that the findings may not be generalizable to other groups.

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“As predicted, when added to [usual treatment], CBT had significantly greater success in reducing both ADHD symptoms and improving occupational and social functioning than [usual treatment] alone, and the sizes of these effects were large,” the authors concluded. Future studies should assess the intervention in a larger sample with a broader range of patients and therapists.


Dittner AJ, Hodsoll J, Rimes KA, Russell AJ, Chalder TC. Cognitive-behavioural therapy for adult attention-deficit hyperactivity disorder: a proof of concept randomised controlled trial [published online December 27, 2017]. Acta Psychiatr Scand. doi: 10.1111/acps.12836