Dialectical behavioral therapy for adult attention deficit/hyperactivity disorder: A meta-analysis of randomized controlled trials.

BACKGROUND

Adult Attention deficit/hyperactivity disorder (ADHD) is typically treated with pharmacotherapy, but issues like adverse effects and treatment discontinuation remain challenging. While dialectical behavioral therapy (DBT) has shown promise in treating adult ADHD, there is limited literature that synthesizes new data, evaluates overall efficacy, and explores DBT adaptations. This study aims to assess DBT's effectiveness in reducing ADHD symptoms, alleviating comorbid conditions like anxiety and depression, and improving quality of life in adults.

METHODS

A comprehensive search of PsycINFO, PubMed, Embase, and ScienceDirect was conducted up to June 30, 2024. Randomized controlled trials (RCTs) comparing DBT (with at least two training modules) to standard treatments, placebo, or no treatment/waitlist controls were included. Standardized mean differences (SMDs) were pooled using random-effects models. Publication bias was assessed via funnel plots, the trim-and-fill method, and Egger's tests. Risk of bias and evidence certainty were evaluated using RoB 2 and GRADEPro.

RESULTS

Of 366 identified articles, 8 RCTs met inclusion criteria, totaling 850 participants, with follow-up data for 533. Meta-analysis showed DBT moderately reduced ADHD symptoms (SMD = -0.51 [-0.76, -0.25]) and improved quality of life (SMD = 0.41 [0.15, 0.66]) compared to controls.

CONCLUSIONS

These findings suggest DBT's potential as a clinical treatment for adult ADHD, offering an alternative to medication and addressing functional challenges. New DBT adaptations may enhance care accessibility and treatment adherence.