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ESCAlate – Adaptive treatment approach for adolescents and adults with ADHD: study protocol for a randomized controlled trial

Zinnow, Toivo ; Banaschewski, Tobias ; Fallgatter, Andreas J. ; Jenkner, Carolin ; Philipp-Wiegmann, Florence ; Philipsen, Alexandra ; Retz, Wolfgang ; Sobanski, Esther ; Thome, Johannes ; Rösler, Michael

In: Trials, 19 (2018), Nr. 280. pp. 1-15. ISSN 1468-6694

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Download (1MB) | Lizenz: Creative Commons LizenzvertragESCAlate – Adaptive treatment approach for adolescents and adults with ADHD: study protocol for a randomized controlled trial by Zinnow, Toivo ; Banaschewski, Tobias ; Fallgatter, Andreas J. ; Jenkner, Carolin ; Philipp-Wiegmann, Florence ; Philipsen, Alexandra ; Retz, Wolfgang ; Sobanski, Esther ; Thome, Johannes ; Rösler, Michael underlies the terms of Creative Commons Attribution 4.0

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Abstract

Background: Over the last decade, a wide range of attention-deficit/hyperactivity disorder (ADHD) treatment approaches for adults, including both pharmacological interventions and psychosocial treatments, have been proposed and observed to be efficient. In practice, individual treatment concepts are based on results of clinical studies as well as international guidelines (NICE Guidelines) that recommend a step-by-step treatment approach. Since the evidence supporting this approach is limited, the aim of the present study is to determine an optimal intervention regarding severity levels of ADHD symptomatology conducting a randomized controlled trial.

Method: We aim to include 279 ADHD subjects aged between 16 and 45 years. First, participants are randomized to either a face-to-face psychoeducation, telephone assisted self-help (TASH), or a waiting control group (Step 1). All participants assigned to the control group are treated using TASH after a 3-month waiting period. Participants are then allocated to one of three groups, based on their remaining severity level of ADHD symptoms, as (1) full responder, (2) partial responder, or (3) non-responder (Step 2). Full responders receive counseling, partial responders receive either counseling only or counseling and neurofeedback (NF), and non-responders receive either pharmacological treatment only or pharmacological treatment and NF, followed by a 3 month period without intervention.

Discussion: The naturalistic sample is one of the study’s advantages, avoiding highly selective inclusion or exclusion criteria. The efficacy of an evidence-based stepped care intervention is explored by primary (reduction of severity of ADHD symptoms) and secondary outcomes (functional outcomes, e.g., quality of life, anger management, enhancement of psychosocial well-being). Predictors of therapeutic response and non-response are being investigated at each step of intervention. Further, sex differences are also being explored.

Trial registration: This study is registered by the German Trial Register (reference number: DRKS00008975 ), 23 October 2015.

Item Type: Article
Journal or Publication Title: Trials
Volume: 19
Number: 280
Publisher: BioMed Central
Place of Publication: London
Date Deposited: 04 Jun 2018 08:01
Date: 2018
ISSN: 1468-6694
Page Range: pp. 1-15
Faculties / Institutes: Medizinische Fakultät Heidelberg > Psychosomatische Universitätsklinik
Subjects: 610 Medical sciences Medicine
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