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- Title
ESCAlate -- Ein adaptiver Behandlungsansatz für Jugendliche und Erwachsene mit ADHS.
- Authors
Zinnow, Toivo; Banaschewski, Tobias; Fallgatter, Andreas J.; Jenkner, Carolin; Millenet, Sabina; Philipsen, Alexandra; Retz, Wolfgang; Sobanski, Esther; Thome, Johannes; Rösler, Michael
- Abstract
In the treatment of adult ADHD, both pharmacological interventions and psychosocial treatments have been shown to be effective. However, in day-to-day clinical routine, treatment is less influenced by the outcomes of clinical trials than by treatment guidelines and requirements of national institutions (Federal Joint Committee). The main aspect of these regulations is the requirement that a step-by-step approach, starting with low-threshold interventions, is most appropriate for treatment in adult ADHD patients. Unfortunately, almost all clinical studies investigate the effects of individual therapeutic strategies. The tiered supply model does not seem to have been sufficiently validated yet. This is exactly where the ESCAlate study described below would like to start. ESCAlate is a randomized, controlled trial. 279 patients between the ages of 16.00 and 45,11 years will be enrolled in the treatment program, which is divided into several sections. In a first stage of treatment, patients are randomized into three groups: Individualized Psychoeducation (PE), Self-Helped Telephone Assisted Self-Help (TASH), or Waiting Control Group. All patients in the waiting group receive treatment with TASH after a waiting period of three months. In the second part of the treatment, patients are divided into the three groups full responders, partial responders and non-responders according to the severity of their persistent symptoms. Patients classified as full-responders receive behavioral-oriented coaching. Partial responders also receive this coaching, whereby in this group patients can be randomized to an additionally neurofeedback training (NF). Non-responders receive pharmacological treatment with methylphenidate and can be randomized to the additionally neurofeedbacktraining. ESCAlate is characterized by a relatively naturalistic sampling composition, as it does away with highly specific inclusion and exclusion criteria in order to obtain a patient sample that reflects the patients' daily routine in the practices. The effectiveness of an evidence-based intervention with graded treatment is assessed by primary (reduction in the severity of ADHD symptoms) and secondary outcomes (functional outcomes such as quality of life, anger management, increase in psychosocial well-being). Therapeutic response/non-response predictors are evaluated at each step of the intervention. In addition, any gender differences can be investigated.
- Subjects
ATTENTION-deficit hyperactivity disorder; THERAPEUTICS; PSYCHOEDUCATION; ADOLESCENCE; TRAILS
- Publication
Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 2018, Vol 66, Issue 4, p219
- ISSN
1661-4747
- Publication type
Article
- DOI
10.1024/1661-4747/a000360