Adolescents with ADHD resistant to medication reduce symptoms after a psychological treatment in group

Researchers of the group of Psychiatry, Addiction and Mental Health of the Vall d'Hebron Institute of Research (VHIR) have reduced the symptoms of adolescents medicated for Attention Deficit Hyperactivity Disorder (ADHD) using a cognitive-behavioral group therapy. The results of psychological treatment have been published in the most prestigious journal in the field of youth psychiatry, the Journal of the American Academy of Child and Adolescent Psychiatry.

The study led at VHIR was held at the Vall d'Hebron University Hospital and the Hospital Clinic between April 2012 and May 2014 on 119 adolescents between 15 and 21 years, treated with either of the two drugs used with ADHD. All patients continued with medication, but about half received cognitive behavioral therapy, and the rest simply continued with routine visits to psychiatry.

At the end of the psychological treatment, which consisted of 12 group sessions of one hour a week, the symptoms of the disorder were reduced in these young people. "With the cognitive behavioral group treatment we can reduce the symptoms of adolescents with severe ADHD, especially those regarding the inattention and impulsivity," said Dr. José Antonio Ramos Quiroga, study director and program coordinator of ADHD at Vall d'Hebron University Hospital.

According to the VHIR researcher, psychological treatment makes sense because "medication can increase the ability of patients to maintain and make better care and reduce impulsivity; but the drug does not help them get organized enough".

The aim of the psychological treatment was precisely to provide teenagers strategies and skills to compensate for their symptoms, whether cognitive or behavioral. 12 sessions were divided into two modules, directed by Raquel Vidal, Rio Hortega researcher at VHIR at the time of the study and clinical psychologist at the Vall d'Hebron University Hospital. In the first module she offered strategies to control impulsivity: self-control techniques, identification of triggers and warning signs to regulate anger, interpersonal skills to accept criticism, handling frustration and motivational strategies. On the other hand, in the second module she focused on techniques for maintaining attention: strategies for planning, problem solving and decision making, ability to postpone events and skills to reduce distractions and distracting thoughts. All the techniques used were collected in the first part of the book "Cognitive-behavioral Treatment for Adolescents with ADHD and cannabis, published in 2014.

ADHD is a neurodevelopmental disorder that affects between 3 and 5% of the population during childhood, and remains more than half of the patients during adolescence. The most common symptoms are inattention, disorganization, lack of impulse control, emotional instability, hyperactivity, and even oppositional defiant symptoms. Persistent ADHD in adolescence is associated with a poor academic performance, difficulties in maintaining relationships, drug abuse and risk driving and sex.

This study is innovative because it has used the largest sample to date investigated in adolescents with ADHD in the psychological field, and focused on group therapy among patients themselves, without involving the family or the school in the treatment.

Given the success of the results, researchers and specialists in the Vall d'Hebron continue giving adolescents with ADHD these sessions and they are looking how to adapt them to study patients with other neurodevelopmental disorders such as Tourette syndrome