About this trial
Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders (SUDs) is a highly common comorbid condition associated with serious medical and psychosocial consequences. However, and despite the international consensus recommending integrated treatment for this comorbidity, few studies tested the efficacy of specific psychotherapeutic treatment for this comorbidity.
The aim of this study is to test the efficacy of a specific group Cognitive and Behavioral Therapy (CBT) for the treatment of adults with this comorbidity.
This is a longitudinal, randomized controlled intervention study utilizing a crossover design between the intervention and treatment-as-usual (TAU) waitlist condition, aimed at testing the effectiveness of an integrated psychotherapeutic group treatment for adults with comorbid Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders (SUDs).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age 18 or older ;
Suffer from at least one moderate to severe SUD regarding the DSM-5 (tobacco excluded) ;
Being currently treated for a SUD by a physician of a psychologist ;
Being diagnosed with an ADHD according to the DIVA 2.0 of DIVA-5 ;
Disqualifiers
Age under 18;
Pregnant or breastfeeding women;
Not having sign the consent form;
Major difficulties in understanding and/or expressing themselves in french;
Trial design
Crossover
Treatments tested in this trial
TAU+integrated group CBT
Other interventionTAU+integrated group CBT : participants receive a group psychotherapeutic intervention of Integrated CBT lasting eight weekly two-hour sessions, in parallel with their usual individual care. The sessions are led by a psychologist trained and certified in the practice of CBT and a psychiatrist specialized in addiction medicine. The psychotherapeutic intervention follows a fixed structure and is inspired by the CBT manual for the management of ADHD associated with SUDs published by Matthys et al. (2018). This intervention includes modules on planning and organization, time and distraction management, emotional regulation, work on impulsive behaviors and social skills, cognitive work, as well as substance use management and relapse prevention. The sessions will be punctuated by regular breaks to ensure participants' comfort and the integration of the skills worked on during the sessions. TAU : participants receive their usual care, in exception of group psychotherapeutic interventions.
Treatment groups
Trial outcomes
Primary outcomes
Emotion dysregulation
Emotion dysregulation subscale of the Adult Self Report Scale for ADHD ( ASRS-31). The scale score ranges from 0 (low dysregulation) to 16 (high dysregulation).
Secondary outcomes
Substance use
Description: Frequency and quantity of substance in the last 15 days, assessed with the Timeline Follow-Back Questionnaire (TLFB)
Self-confidence in abstinence
Description: Self-confidence in the capacity to not use substance in several tempting contexts, assessed with the Brief Situational Confidence Questionnaire (BSCQ). The scale score ranges from 0% (low self-confidence) to 16 (high self-confidence).
Craving
Craving frequency and intensity measured with the Craving Experience Questionnaire (CEQ).The frequency scale ranges from 11 (very infrequent) to 110 (always) and the intensity scale ranges from 11 (low) to 110 (extreme).
Nicotine dependence
Nicotine dependence assessed with the Heaviness of Smoking Index (HSI).The total score ranges from 0 (no dependence) to 6 (severe dependence).
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