Wirksamkeit Verhaltenstherapie

Transkript

1 Wirksamkeit Verhaltenstherapie Symptomatische Normalisierungsraten in der MTA-Studie (14 Monate) Prozent Alltagsübl. Behandlung Pharmako + Verhaltenstherapie Verhaltenstherapie Pharmakotherapie Swanson et al. (21). Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment. J. Am. Acad. Child and Adolesc. Psychiatry 4,

2 Kölner Adaptive Multimodale Therapie-Studie () Kölner Adaptive Multimodale Therapie-Studie (): Einschlusskriterien Stichprobe N=75 Alter 6-1 Jahre Schule Klasse 1-4 Intelligenz IQ >= 84 Diagnose ADHS: ICD-1 (Prel. RDC) oder DSM-IIIR Döpfner et al. (24). Effectiveness of an adaptive multimodal treatment in children with Attention Deficit Hyperactivity Disorder global outcome. European Child & Adolescent Psychiatry, 12 (supplement 1), I I

3 Sample Characteristics: Age and Gender Age Ratio: 14: 1 Range: 6;4 1;7; median 8;3 years Döpfner et al. (24). Effectiveness of an adaptive multimodal treatment in children with Attention Deficit Hyperactivity Disorder global outcome. European Child & Adolescent Psychiatry, 12 (supplement 1), I I 129. Normalisierungsraten für individuelle Probleme Behavior Therapy (n=37) 11 % change to BT 27 % change to MED Psychoeducation / Behavior Therapy + Medication (n=38) 8 6 % 4 2 Parent Teacher Parent Teacher Döpfner et al. (24). Effectiveness of an adaptive multimodal treatment in children with Attention Deficit Hyperactivity Disorder global outcome. European Child & Adolescent Psychiatry, 12 (supplement 1), I I

4 18 Monate Follow up (Eltern & Lehrer) ** ADHD-Symptoms (Symptom-Checklist; n=56) Parent Ratings Teacher Ratings 2,5 2, ,5 1,5 1 1,5,5 Pre Post FU6 FU18 Pre Post FU6 FU18 no MED (n=27) MED (n=29) MANOVA: main effect of time (F=28.9; df=3,63;p<.1) no main effect of treatment no interaction effect no Med (n=27) MED (n=29) MANOVA: main effect of time (F=35.; df=3,5;p<.1) no main effect of treatment interaction effect (F=8.3; df=3,5;p<.1) Doepfner et al. (23): -Study 18 month follow up. Unpublished manuscript, University of Cologne. 4

5 Parent Ratings Total-Score (CBCL / TRF) Teacher Ratings MANOVA: main effect of time (F=28.7; df=3,52;p<.1) no main effect of treatment no interaction effect MANOVA: main effect of time (F=25.5; df=3,52;p<.1) no main effect of treatment interaction effect (F=5.9; df=3,52;p<.1) Doepfner et al. (23): -Study 18 month follow up. Unpublished manuscript, University of Cologne. 8½ Jahres Follow - up 5

6 Sample Characteristics at Follow-up (n= 75) Age Range: 16, 22,5; median 18,1 years, mean 18,3 (±1,6) Doepfner et al. (25): -Study 8 ½ year follow up. Unpublished manuscript, University of Cologne. 2,5 2 1,5 Raw Score Parent Ratings of ADHD Symptoms (Symptom-Checklist; n=63) MANOVA: main effect time (p<.1) -,2 -,4 -,6 -,8-1 -1,2-1,4-1,6-1,8-2 Change Scores (effect sizes) Pre-Post Post-F.up Pre-F.up Cohen's d 1 % Raw Score < 1,5 Total Sample (63) With MPH (32) Without MPH (31) Years Doepfner et al. (25): -Study 8 ½ year follow up. Unpublished manuscript, University of Cologne Pre Post F.up 6

7 interdisziplinäre Kompetenznetze ADHS im Schnittfeld von Pädagogik Psychologie Medizin 7

8 ADHS im Schnittfeld von Pädiatrie Sonder- / Regelschule Kinder- / Jugendpsychiatrie ADHS Jugendhilfe Psycho therapie Frühförderung / Ergo- / Mototherapie Leitung: Prof. Dr. M. Döpfner (Köln), Dr. J. Krause (München), Dr. K. Skrodzki (Forchheim), Prof. Dr. F. Resch (Heidelberg) gefördert durch das 8

9 Ziele 1. Information für Experten, Betroffene und Angehörige Internetbasiertes Experten- Informationssystem Internetbasiertes Patienten- und Angehörigen-Informationssystem 2. Öffentlichkeitsarbeit Ausarbeitung von Stellungnahmen 3. Unterstützung der Arbeit regionaler ADHS- Netze Unterstützung bestehender regionaler Netze Vernetzung bestehender regionaler Netze Erleichterung der Bildung neuer regionaler Netze 9