Investigating the efficacy of integrated cognitive behavioral therapy for adult treatment seeking substance use disorder patients with comorbid ADHD: study protocol of a randomized controlled trial

• Published in: BMC psychiatry Vol. 13; no. 1; p. 132
• Main Authors: van Emmerik-van Oortmerssen, Katelijne, Vedel, Ellen, Koeter, Maarten W, de Bruijn, Kim, Dekker, Jack J M, van den Brink, Wim, Schoevers, Robert A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.05.2013; BioMed Central
• Subjects: Addictions; Addictive behaviors; Adolescent; Adult; Adults; Aged; Alcohol; Anxiety; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit hyperactivity disorder; Behavior modification; Care and treatment; Clinical Protocols; Clinical trials; Cognitive therapy; Cognitive Therapy - methods; Comorbidity; Cost analysis; Diagnosis, Dual (Psychiatry); Drug abuse; Drug therapy; Drug use; Evidence-based medicine; Female; Humans; Hypotheses; Impulsivity; Male; Mental depression; Mental disorders; Metacognition; Methods; Middle Aged; Neuropsychology; Patient outcomes; Patients; Psychiatry; Quality of life; Research Design; Self Report; Study Protocol; Substance abuse; Substance abuse treatment; Substance use disorder; Substance-Related Disorders - complications; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; Treatment Outcome; Netherlands
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/1471-244X-13-132

Attention deficit hyperactivity disorder (ADHD) frequently co-occurs with substance use disorders (SUD). The combination of ADHD and SUD is associated with a negative prognosis of both SUD and ADHD. Pharmacological treatments of comorbid ADHD in adult patients with SUD have not been very successful. Recent studies show positive effects of cognitive behavioral therapy (CBT) in ADHD patients without SUD, but CBT has not been studied in ADHD patients with comorbid SUD. This paper presents the protocol of a randomized controlled trial to test the efficacy of an integrated CBT protocol aimed at reducing SUD as well as ADHD symptoms in SUD patients with a comorbid diagnosis of ADHD. The experimental group receives 15 CBT sessions directed at symptom reduction of SUD as well as ADHD. The control group receives treatment as usual, i.e. 10 CBT sessions directed at symptom reduction of SUD only. The primary outcome is the level of self-reported ADHD symptoms. Secondary outcomes include measures of substance use, depression and anxiety, quality of life, health care consumption and neuropsychological functions. This is the first randomized controlled trial to test the efficacy of an integrated CBT protocol for adult SUD patients with a comorbid diagnosis of ADHD. The rationale for the trial, the design, and the strengths and limitations of the study are discussed.