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Does the treatment of maternal attention deficit and hyperactivity disorder (ADHD) enhance the efficacy of a behavioural parent training for the treatment of their children’s ADHD? Study protocol of a randomized controlled multicentre trail

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ADHD Attention Deficit and Hyperactivity Disorders

Abstract

Heritability of deficit and hyperactivity disorder (ADHD) is high. Thus, frequently both children and parents are affected. Parental ADHD often has a negative impact on parent–child interactions and may constitute a significant barrier to a successful treatment of the child’s ADHD. The objective of our randomized controlled multicentre trial is to evaluate whether the treatment of maternal ADHD improves the efficacy of a behavioural parent training for children’s ADHD. One hundred and forty-four mother–child pairs, both affected by ADHD according to DSM-IV, will be treated at five sites in Germany. Mothers are randomized to manualized cognitive-behavioural group psychotherapy plus open methylphenidate treatment or to control treatment (supportive counselling). After 13 weeks of treatment, manualized behavioural parent training will be administered to all mother–child pairs. Therapists are graduated psychologists or physicians. Treatment integrity will be established by independent supervision. Primary endpoint (child’s externalizing symptoms) is rated by interviewers blind to the mother’s treatment allocation. Intention-to-treat analysis will be performed within a linear regression model (Current Controlled Trials ISRCTN73911400).

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Acknowledgments

Our network on psychotherapy of ADHD is supported by the German Federal Ministry of Education and Research (Bundesministerium fuer Bildung und Forschung, BMBF; 01GV0605, 01GV0606) within the framework ‘research networks on psychotherapy’. Members of the AIMAC study group (ADHD in Mothers and Children; coordinating investigator: Prof. Dr. A. Warnke, Wuerzburg University Hospital) are our colleagues at the study sites at Freiburg (University Medical Center Freiburg: Department of Psychiatry and Psychotherapy, Director: Prof. Dr. M. Berger; Department of Child and Adolescent Psychiatry and Psychotherapy, Director: Prof. Dr. E. Schulz), Homburg (Saarland University Hospital and Saarland University Faculty of Medicine: Institute for Forensic Psychology and Psychiatry, Director: Prof. Dr. M. Roesler; Department of Child and Adolescent Psychiatry and Psychotherapy, Director: Prof. Dr. A. v. Gontard), Mannheim (Central Institute for Mental Health: Clinic for Psychiatry and Psychotherapy, Director: Prof. Dr. A. Meyer-Lindenberg; Clinic for Child and Adolescent Psychiatry and Psychotherapy, Director: Prof. Dr. Dr. T. Banaschewski), Berlin (Charité, University Medicine, Campus Benjamin Franklin, Department of Psychiatry and Psychotherapy, Director: Prof. Dr. I. Heuser; Campus Virchow-Klinikum, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Director: Prof. Dr. U. Lehmkuhl), Wuerzburg (Wuerzburg University Hospital: Department of Psychiatry, Psychosomatics and Psychotherapy, Director: Prof. Dr. J. Deckert; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Director: Prof. Dr. A. Warnke), members of the Clinical Trials Center at University Medical Center Freiburg (Director: Prof. Dr. H. Maier-Lenz) as well as members of the Data Monitoring and Safety Committee (Prof. Dr. Dr. H. Remschmidt, Prof. Dr. G. Wassmer, PD Dr. N. Wodarz). Independent supervision is carried out by staff members at the Department of Child and Adolescent Psychiatry and Psychotherapy at the Cologne University Hospital (parent training) and at the Institute for Psychology of Freiburg University in cooperation with colleagues in private practice (treatment of mothers). The three other projects in our network on the psychotherapy of ADHD (coordinator: Prof. Dr. A. Warnke, Wuerzburg University Hospital) are coordinated by Dr. A. Philipsen (University Medical Center Freiburg, Psychotherapy of adult ADHD), Prof. Dr. L. Tebartz van Elst (University Medical Center Freiburg, functional and morphometric brain mapping) and Prof. Dr. K.-P. Lesch (Wuerzburg University Hospital, molecular genetics). We thank Dr. Fischer (MEDICE Arzneimittel Puetter GmbH & Co. KG) for his support in preparing the study protocol and case report forms as well as his assistance in SAE management. Prof. F. Mattejat gave helpful expert advice in planing the study and Dr. M. Romanos and MA. V. Rost assisted in reviewing the manuscript. We are also grateful that HOGREFE and BELTZ publishers provided treatment manuals for free. We gratefully thank all participating children and mothers and all our partners for their cooperation.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Wuerzburg, Fuechsleinstr. 15, 97080, Wuerzburg, Germany

    Thomas Jans, Manfred Gerlach & Andreas Warnke

  2. Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, 79104, Freiburg, Germany

    Alexandra Philipsen

  3. Clinical Trials Center, University Medical Center Freiburg, Elsaesser Str. 2, 79110, Freiburg, Germany

    Erika Graf & Gabriele Ihorst

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  1. Thomas Jans
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  2. Alexandra Philipsen
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  3. Erika Graf
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  4. Gabriele Ihorst
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  5. Manfred Gerlach
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  6. Andreas Warnke
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Correspondence to Thomas Jans.

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For the AIMAC study group (AIMAC: ADHD in mothers and children, study sites: University Hospitals of Wuerzburg, Freiburg, Saarland and Berlin; Central Institute of Mental Health Mannheim).

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Jans, T., Philipsen, A., Graf, E. et al. Does the treatment of maternal attention deficit and hyperactivity disorder (ADHD) enhance the efficacy of a behavioural parent training for the treatment of their children’s ADHD? Study protocol of a randomized controlled multicentre trail. ADHD Atten Def Hyp Disord 1, 33–45 (2009). https://doi.org/10.1007/s12402-009-0004-4

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