Efficacy of Cognitive Behavioral Therapy and Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: A Systematic Review

Abstract

The treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents can be challenging and involve a combination of pharmacologic and non-pharmacological approaches. Using recent literature, we aim to identify the effectiveness of cognitive behavioral therapy (CBT) and methylphenidate (MPH) in reducing the symptoms and improving the quality of life. The investigators conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Investigators independently conducted a routine search on PubMed and Google Scholar for articles published within the last five years through July 30, 2022. Fourteen studies were identified as generally good quality but with some limitations. The final analysis included 2098 patients with an age range of three to eighteen. Nine studies reporting the efficacy of MPH in children, adolescents, or both had different formulations and doses. Six studies documenting the effectiveness of CBT had varying sessions, duration per therapy, modality of administration, and participants. The diagnostic assessment measures showed that the parent symptom rating was the highest and appeared in 11 studies, reflecting the burden on the family. In addition, a structured-self-rated questionnaire rating appeared in eight studies, and two diagnostic assessment measures, teacher symptom rating and investigators, appeared in six.The studies demonstrated significant reductions in the primary symptoms of ADHD at assessment, which led to improved behavioral and functional status with a reduced impact on family and society. Further trials are needed to understand the benefits of CBT and MPH when combined to reduce psychiatry co-morbidities and improve learning and overall quality of life in the long term.

Terapia Conductual -Cognitiva en Problemas Infantiles

“…Justamente por ello, es que el trabajo multidisciplinario comienza a ser considerado como esencial para estos casos, donde ciertos fármacos ofrecidos por la psiquiatría van ganando peso en mejorar la disposición del menor con TDAH (Jean-Tron et al, 2020;Ojinna et al, 2022) para llevar de forma complementaria la intervención de orientación conductual, donde los paquetes de entrenamiento a los padres, como procedimiento complementario al trabajo con el menor, van ganando peso. Al respecto se han ido proponiendo formas de evaluación a través de test como lo reportaría Puerta (2004), tanto sobre la sintomatología del TDAH, como evaluando una probable comorbilidad con un trastorno disocial de la conducta y las impresiones de los padres.…”

“…Como lo dice la literatura (Carrasco-Chaparro, 2022; Van Diepen y Van Diepen, 2021) el TDAH no constituye un problema generado por la crianza, sino que es la consecuencia de una combinación de factores, motivo por el cual se Terapia Conductual-Cognitiva en problemas infantiles: un caso de aplicación de estrategias a través del entrenamiento a los padres 22 encuentra en la categoría de trastorno del neurodesarrollo. En este sentido los procedimientos conductuales no suelen ser aplicados de forma aislada, sino que son combinados con farmacología conductual, como lo mostraría la revisión realizada porOjinna et al (2022) y Lopez et al (2018.…”