Abstract

Attention Deficit Hyperactivity Disorder (ADHD) negatively impacts Quality of Life (QoL) in adults. Earlier studies on pharmacological treatment have shown short-term beneficial effects on QoL. No data are available on long-term effects on multimodal psychosocial and/or pharmacological interventions. The Comparison of Methylphenidate and Psychotherapy in Adult ADHD Study (COMPAS), a prospective, multicenter randomized clinical trial, compared cognitive behavioral group psychotherapy (GPT) with individual clinical management (CM) and methylphenidate (MPH) with placebo (Plac) (2 × 2 factorial design over a period of 52 weeks). Change of QoL was measured after three months of intensive treatment, after 26 weeks, and after one year of maintenance treatment, using the Quality of life enjoyment and satisfaction questionnaire (Q-LES-Q, eight subscales). A follow-up was performed 1.5 years after treatment completion. Q-LES-Q scores were analyzed descriptively (means and confidence intervals). A linear regression model was used to test for significant differences between the four treatment arms. The full analysis set comprised 419 patients. Q-LES-Q scores increased between baseline and the end of treatment across all Q-LES-Q subscales (with exception of stable scores in the physical health/activities subscale in the CM + Plac group) and remained stable improved at follow-up. Regression analyses did not show any significant differences between the four treatment conditions. COMPAS is the first study to demonstrate stable and long-term improvements of QoL after multimodal treatment regardless of medication with MPH or Placebo, and regardless of structured GPT or individual CM. Trial registration: ISRCTN54096201

摘要

注意缺陷多动障碍 (ADHD) 会对成年人的生活质量 (QoL) 产生负面影响。早期的药物治疗研究表明对 QoL 有短期的有益影响。没有关于多模式社会心理和/或药物干预的长期影响的数据。成人 ADHD 研究 (COMPAS) 中哌甲酯和心理治疗的比较，一项前瞻性、多中心随机临床试验，比较了认知行为团体心理治疗 (GPT) 与个体临床管理 (CM) 和哌甲酯 (MPH) 与安慰剂 (Plac) (2 × 52 周内的 2 因子设计）。使用生活质量享受和满意度问卷（Q-LES-Q，8 个分量表）测量强化治疗三个月后、26 周后和维持治疗一年后 QoL 的变化。治疗完成后 1.5 年进行随访。描述性分析 Q-LES-Q 分数（平均值和置信区间）。使用线性回归模型来测试四个治疗组之间的显着差异。完整的分析集包括 419 名患者。Q-LES-Q 评分在所有 Q-LES-Q 分量表的基线和治疗结束之间增加（CM + Plac 组中身体健康/活动分量表的稳定分数除外），并在随访时保持稳定改善. 回归分析没有显示四种处理条件之间的任何显着差异。COMPAS 是第一项证明多模式治疗后 QoL 稳定和长期改善的研究，无论使用 MPH 或安慰剂药物治疗，也无论结构化 GPT 或个体 CM。试用注册：