ABSTRACT
OBJECTIVE: To investigate efficacy, patient acceptability and feasibility of formulation-based cognitive-behavioural therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD). NICE guidelines for adult ADHD recommend further research into psychological treatments. METHOD: Sixty participants with adult ADHD were randomly allocated to treatment as usual (TAU) vs. TAU plus up to 16 sessions of individual formulation-based CBT for ADHD. RESULTS: Adding formulation-based CBT to TAU for ADHD significantly improved ADHD symptoms on the Barkley Current Symptoms Scale and scores on the Work and Social Adjustment Scale. Adjusted effect sizes (ES) were 1.31 and 0.82 respectively. There were also significant improvements on secondary outcomes including independently evaluated clinical global improvement, self-rated anxiety, depression, global distress and patient satisfaction (adjusted effect sizes 0.52-1.01). CONCLUSIONS: This is the first randomised controlled trial to provide preliminary evidence of efficacy and acceptability of individual formulation-based CBT for ADHD when added to TAU over TAU alone. This approach now needs to be tested in a larger multicentred randomised controlled trial.
Subject(s)
Attention Deficit Disorder with Hyperactivity/therapy , Cognitive Behavioral Therapy/methods , Outcome Assessment, Health Care , Patient Acceptance of Health Care , Adult , Feasibility Studies , Female , Humans , Male , Middle Aged , Proof of Concept StudyABSTRACT
OBJECTIVES: Fatigue is a common feature of physical and neurological disease as well as psychiatric disorders, often reported amongst patients' most severe and distressing symptoms. A large number of scales have been developed attempting to measure the nature, severity and impact of fatigue in a range of clinical populations. The aim of the present review is to guide the clinician and researcher in choosing a scale to suit their needs. METHODS: Database searches of Medline, PsycINFO and EMBASE were undertaken to find published scales. RESULTS: Details of 30 scales are reported. These vary greatly in how widely they have been used and how well they have been evaluated. The present review describes the scales and their properties and provides illustrations of their use in published studies. CONCLUSIONS: Recommendations are made for the selection of a scale and for the development and validation of new and existing scales.
