PDF(Pubmed)
Abstract：
BACKGROUND: Adult attention-deficit/hyperactivity disorder (ADHD) represents a significant public health burden. ADHD is often comorbid with many other psychiatric disorders, with a high co-occurrence with depression. However, there is a paucity in our understanding of the potential impact of treating patients\' ADHD on their depressive symptoms. The primary objective of this study was to assess the effect of treating adult ADHD on comorbid depressive symptoms without directly administering treatment for depression in an integrated behavioral health clinic in the primary care setting.
METHODS: We performed a retrospective chart review between April 2021 and May 2022 on adult patients treated in the Primary Care Adult Integrated Behavioral Health Clinic at an urban family medicine residency clinic. For patients with ADHD, we administered the Adult ADHD Self-Report Scale (ASRS-v1.1) to serve as a marker of ADHD symptom burden and the nine-item Patient Health Questionnaire (PHQ-9) to serve as a marker of depressive symptom burden. We administered the questionnaires prior to initiating ADHD treatment and again at the three-month follow-up visit. The ADHD treatment included pharmacotherapy and brief psychological interventions targeted at ADHD. We compared the ASRS scores and PHQ-9 scores at baseline and after three months to determine whether ADHD treatment had any impact on PHQ-9 scores.
RESULTS: At baseline, the average ASRS score was 11.3 and the average PHQ-9 score was 8.25. Comparing scores after three months of intervention to the initial scores, our preliminary results demonstrated a trend of improvement in both ASRS and PHQ-9 scores. A total of 75% (n=24/32) of the patients had an improvement in ASRS scores, and 56.7% (n=17/30) of the patients had an improvement in PHQ-9 scores at three months. At three months, there was a decline in PHQ-9 scores with a decrease in ASRS scores following treatment.
CONCLUSIONS: Our preliminary results suggest that integrated behavioral health treatment of ADHD using a combination of pharmacological and non-pharmacological interventions may play a role in improving comorbid depressive symptoms.
METHODS: We performed a retrospective chart review between April 2021 and May 2022 on adult patients treated in the Primary Care Adult Integrated Behavioral Health Clinic at an urban family medicine residency clinic. For patients with ADHD, we administered the Adult ADHD Self-Report Scale (ASRS-v1.1) to serve as a marker of ADHD symptom burden and the nine-item Patient Health Questionnaire (PHQ-9) to serve as a marker of depressive symptom burden. We administered the questionnaires prior to initiating ADHD treatment and again at the three-month follow-up visit. The ADHD treatment included pharmacotherapy and brief psychological interventions targeted at ADHD. We compared the ASRS scores and PHQ-9 scores at baseline and after three months to determine whether ADHD treatment had any impact on PHQ-9 scores.
RESULTS: At baseline, the average ASRS score was 11.3 and the average PHQ-9 score was 8.25. Comparing scores after three months of intervention to the initial scores, our preliminary results demonstrated a trend of improvement in both ASRS and PHQ-9 scores. A total of 75% (n=24/32) of the patients had an improvement in ASRS scores, and 56.7% (n=17/30) of the patients had an improvement in PHQ-9 scores at three months. At three months, there was a decline in PHQ-9 scores with a decrease in ASRS scores following treatment.
CONCLUSIONS: Our preliminary results suggest that integrated behavioral health treatment of ADHD using a combination of pharmacological and non-pharmacological interventions may play a role in improving comorbid depressive symptoms.
摘要：
背景：成人注意力缺陷/多动障碍（ADHD）代表了重大的公共卫生负担。多动症通常与许多其他精神疾病并存，与抑郁症的高并发性。然而,我们对治疗ADHD患者对其抑郁症状的潜在影响缺乏了解。这项研究的主要目的是评估在初级保健环境中的综合行为健康诊所中，无需直接对抑郁症进行治疗即可治疗成人ADHD对共病抑郁症状的影响。
方法：我们在2021年4月至2022年5月期间对在城市家庭医学住院医师诊所的初级保健成人综合行为健康诊所接受治疗的成年患者进行了回顾性图表审查。对于多动症患者，我们采用成人ADHD自我报告量表(ASRS-v1.1)作为ADHD症状负担的指标,采用9项患者健康问卷(PHQ-9)作为抑郁症状负担的指标.我们在开始ADHD治疗之前和三个月的随访时再次进行了问卷调查。ADHD治疗包括药物治疗和针对ADHD的简短心理干预。我们比较了基线和三个月后的ASRS评分和PHQ-9评分，以确定ADHD治疗是否对PHQ-9评分有任何影响。
结果：在基线时，ASRS平均得分为11.3分,PHQ-9平均得分为8.25分.将干预三个月后的得分与初始得分进行比较，我们的初步结果显示ASRS和PHQ-9评分均有改善趋势.共有75％（n=24/32）的患者ASRS评分有所改善，56.7%(n=17/30)的患者在三个月时PHQ-9评分有所改善。三个月后,治疗后PHQ-9评分下降,ASRS评分下降.
结论：我们的初步研究结果表明，联合应用药物和非药物干预的行为健康综合治疗ADHD可能在改善共病抑郁症状方面发挥作用。
方法：我们在2021年4月至2022年5月期间对在城市家庭医学住院医师诊所的初级保健成人综合行为健康诊所接受治疗的成年患者进行了回顾性图表审查。对于多动症患者，我们采用成人ADHD自我报告量表(ASRS-v1.1)作为ADHD症状负担的指标,采用9项患者健康问卷(PHQ-9)作为抑郁症状负担的指标.我们在开始ADHD治疗之前和三个月的随访时再次进行了问卷调查。ADHD治疗包括药物治疗和针对ADHD的简短心理干预。我们比较了基线和三个月后的ASRS评分和PHQ-9评分，以确定ADHD治疗是否对PHQ-9评分有任何影响。
结果：在基线时，ASRS平均得分为11.3分,PHQ-9平均得分为8.25分.将干预三个月后的得分与初始得分进行比较，我们的初步结果显示ASRS和PHQ-9评分均有改善趋势.共有75％（n=24/32）的患者ASRS评分有所改善，56.7%(n=17/30)的患者在三个月时PHQ-9评分有所改善。三个月后,治疗后PHQ-9评分下降,ASRS评分下降.
结论：我们的初步研究结果表明，联合应用药物和非药物干预的行为健康综合治疗ADHD可能在改善共病抑郁症状方面发挥作用。
