title: Group therapy for adolescents with attention-deficit/hyperactivity disorder: a randomized controlled trial.
abstract: OBJECTIVE
  To determine the efficacy of group cognitive-behavioral therapy (CBT) on adolescents with attention-deficit/hyperactivity disorder (ADHD) who were in pharmacological treatment but still had persistent symptoms.
  
  
  METHODS
  We conducted a multicenter, randomized, rater-blinded, controlled trial between April 2012 and May 2014 in a cohort of 119 adolescents (15-21 years of age). Participants were randomly assigned to 12 manualized group CBT sessions (n = 45) or a waiting list control group (n = 44). Primary outcomes were assessed by a blinded evaluator (ADHD Rating Scale [ADHD-RS], Clinical Global Impression Scale for Severity [CGI-S], Global Assessment of Functioning [GAF]) before and after treatment, as well as by self-report and parent informant ratings.
  
  
  RESULTS
  Of the initial 119 participants enrolled, 89 completed treatment. A mixed-effects model analysis revealed that participants who were assigned to the group CBT sessions experienced significantly reduced ADHD symptoms compared to the control group (ADHD-RS Adolescent: -7.46, 95% CI = -9.56 to -5.36, p < .001, d = 7.5; ADHD-RS Parents: -9.11, 95% CI = -11.48 to -6.75, p < .001, d = 8.38; CGI-S Self-Report: -0.68, 95% CI = -0.98 to -0.39, p < .001, d = 3.75; CGI-S Clinician: -0.79, 95% CI = -0.95 to -0.62, p < .001; d = 7.71). Functional impairment decreased significantly in the CBT group according to parents (Weiss Functional Impairment Scale -4.02, 95% CI = -7.76 to -0.29, p < .05, d = 2.29) and according to the blinded evaluator (GAF: -7.58, 95% CI = -9.1 to -6.05, p < .001, d = 7.51).
  
  
  CONCLUSIONS
  Group CBT associated with pharmacological treatment is an efficacious intervention for reducing ADHD symptoms and functional impairment in adolescents. Clinical trial registration information-CBT Group for Adolescents With ADHD: a Randomized Controlled Trial; http://clinicaltrials.gov/; NCT02172183.
authors: Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona.
authors: Raquel
authors: R
authors: Vidal
authors: Hospital Clínic of Barcelona.
authors: Jordi
authors: J
authors: Castells
authors: Hospital Universitari Vall d'Hebron, ADHD Program, Barcelona, Spain.
authors: Vanesa
authors: V
authors: Richarte
authors: Hospital Universitari Vall d'Hebron, ADHD Program, Barcelona, Spain.
authors: Gloria
authors: G
authors: Palomar
authors: Hospital Clínic of Barcelona.
authors: Marta
authors: M
authors: García
authors: Hospital Clínic of Barcelona.
authors: Rosa
authors: R
authors: Nicolau
authors: Hospital Clinic of Barcelona, (CIBERSAM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and with the University of Barcelona.
authors: Luisa
authors: L
authors: Lazaro
authors: Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona.
authors: Miguel
authors: M
authors: Casas
authors: Hospital Universitari Vall d'Hebron, ADHD (Attention-Deficit/Hyperactivity Disorder) Program, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain, and Universitat Autònoma de Barcelona. Electronic address: jaramos@vhebron.net.
authors: Josep Antoni
authors: JA
authors: Ramos-Quiroga
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D057566:Self Report; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult
keywords: ADHD; cognitive-behavioral therapy; group therapy; psychological treatment