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Published on: June 12, 2020
A randomized controlled multicentre trial on the treatment for ADHD in mothers and children: enrolment and basic
Thomas Jans1, Erika Graf, Christian Jacob
1Department of Child and Adolescent Psychiatry, University Hospital Würzburg, Füchsleinstr. 15, 97080 Würzburg, Germany. jans@kjp.uni-wuerzburg.de
Insights
Treating maternal ADHD alongside behavioral parent training significantly enhances treatment effectiveness for children with ADHD. This study evaluated cognitive behavioral group psychotherapy plus methylphenidate versus supportive counseling for mothers.
Area of Science:
- Child and Adolescent Psychiatry
- Clinical Psychology
- Behavioral Science
Background:
- Parental Attention-Deficit/Hyperactivity Disorder (ADHD) can impede effective treatment for children with ADHD.
- Optimizing treatment for pediatric ADHD may necessitate addressing parental ADHD symptoms concurrently.
Purpose of the Study:
- To investigate if treating maternal ADHD improves the efficacy of behavioral parent training for children's ADHD.
- To compare two treatment strategies for maternal ADHD: cognitive behavioral group psychotherapy plus methylphenidate versus supportive counseling.
Main Methods:
- A randomized controlled trial involving 144 mother-child pairs.
- Mothers were randomized to either cognitive behavioral group psychotherapy plus open methylphenidate or supportive counseling for 3 months.
- Following maternal treatment, all pairs participated in behavioral parent-child training.
Main Results:
- The study enrolled 143 mother-child pairs in the full analysis set, with children averaging 9.4 years old (73% male).
- High rates of combined ADHD subtype were observed in both children (52%) and mothers (66%).
- Significant co-morbidity rates were present in both children (Axis-I: 48%) and mothers (Axis-I: 31%, Axis-II: 20.1%).
Conclusions:
- Maternal ADHD treatment is a critical factor in the success of pediatric ADHD interventions.
- The findings support integrated treatment approaches for families affected by ADHD.
- Further research is warranted to explore the long-term impact of this combined treatment strategy.
Abstract:
Parental ADHD may be a significant barrier to a successful treatment for the child's ADHD. The objective of our randomized controlled trial was to evaluate whether the treatment for maternal ADHD improves the efficacy of a behavioural parent training for children's ADHD. Patient enrolment and a description of the full analysis set (FAS) of mother-child pairs with non-missing baseline data are presented. One hundred and forty-four mother-child pairs were randomized to two treatments for maternal ADHD: cognitive behavioural group psychotherapy plus open methylphenidate treatment or control treatment (supportive counselling). After 3 months of treatment for maternal ADHD, mother-child pairs participated in a behavioural parent-child training. Assessment for eligibility included standardized instruments. After pre-screening out of 444 mother-child pairs, 206 were evaluated for trial participation and 144 were randomized. The FAS was built up by 143 dyads (children: mean age 9.4 years, 73 % males; mothers: mean age: 38.3 years). Fifty-two per cent of the children and 66 % of the mothers had combined ADHD subtype. Current axis-I co-morbidity rates were 48 % in children and 31 % in mothers. Maternal axis-II co-morbidity was 20.1 %. Fifty-seven per cent of the mothers lived together with the father of the index-child, and 29 % were single mothers. Sixty-two per cent had part-time or full-time employment. There was a selection bias excluding mothers with lack of time and effort for participation and mothers affected by coexisting mental and physical illness. Nevertheless, for our trial we were able to collect a sample comparable to routine psychiatric outpatient settings (registration: CCT-ISRCTN73911400, funding: BMBF-01GV0605).
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