Objective

To determine whether comorbid attention-deficit/hyperactivity disorder (ADHD) diagnosis (including subtype) predicts response to cognitive-behavior therapy (CBT) for anxiety in children and to examine change in ADHD symptoms after treatment of primary anxiety.

Method

A sample of 842 children 5 to 18 years of age received CBT for a primary anxiety disorder. A subsample of 94 children met criteria for comorbid mild-to-moderate ADHD, mostly consisting of predominantly inattentive (n = 61) and combined (n = 27) subtypes. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (after treatment and 3- and/or 6-month follow-up) and analyzed using linear and logistic mixed models.

Results

Neither ADHD diagnosis nor subtype predicted response or remission rates for children’s primary anxiety disorders. Children with ADHD also showed modest yet significant improvements in ADHD symptoms after CBT for anxiety.

Conclusion

The present findings support the suitability of manual-based group-based CBT for anxiety treatment in children with nonprimary ADHD. Further research should examine whether the positive outcomes reported can be extended to children with primary or severe ADHD.

中文翻译：

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患有焦虑症和并发注意缺陷/多动障碍的儿童的认知行为疗法

客观的

为了确定并发注意缺陷/多动障碍（ADHD）诊断（包括亚型）是否可预测儿童对焦虑的认知行为疗法（CBT）的反应，并检查原发性焦虑治疗后ADHD症状的变化。

方法

842名5至18岁的儿童因原发性焦虑症接受了CBT。94名儿童的子样本符合轻度至中度ADHD合并症的标准，主要由注意力不集中（n = 61）和合并（n = 27）的亚型组成。结果定义为在每个时间点（治疗后以及3和/或6个月的随访后）的反应（诊断严重性变化）和缓解（无初诊），并使用线性和逻辑混合模型进行分析。

结果

ADHD诊断或亚型均未预测儿童原发性焦虑症的反应或缓解率。患有CHD的焦虑症患儿多动症儿童在ADHD症状上也显示出适度但显着的改善。

结论

本研究结果支持基于手动的基于小组的CBT在非原发性多动症儿童中进行焦虑治疗的适用性。进一步的研究应检查报告的阳性结果是否可以扩展至原发性或重度多动症儿童。