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. 2018 Mar 23;2018(3):CD010840. doi: 10.1002/14651858.CD010840.pub2

Virta 2010.

Methods Randomised controlled trial
Participants Country: Finland
Setting: ambulatory
Age: adults (18–49 years old)
Sample size: 29
Sex: 15 women, 14 men
Inclusion criteria: ADHD diagnosis made by a physician; no diagnosis of psychosis, severe depression or paranoia; deficits of attention, executive functions or working memory identified in an earlier neuropsychological evaluation; no current alcohol dependency or drug use; not receiving a disability pension; no participation in our previous group rehabilitation study; currently not undergoing any other psychological rehabilitation; no medication or medication that has been stable for at least three months
Exclusion criteria: no neuropsychological examination; diagnosis of psychosis, severe depression or paranoia; older age, retired, or current psychological rehabilitation.
Interventions Intervention:
  1. Short‐term individual cognitive‐behavioral therapy (CBT) (10 weekly sessions) (n = 10; 5 participants with specific pharmacotherapy for ADHD and 5 without specific pharmacotherapy).

  2. Cognitive training (CT) (20 sessions taking place twice a week) (n = 9; 5 participants with specific pharmacotherapy for ADHD and 4 without specific pharmacotherapy)


Control: control group (not specified) (n = 10; 7 participants with specific pharmacotherapy for ADHD and 3 without specific pharmacotherapy).
Dosage, timing of dosage and administration of pharmacotherapy were not specified.
Outcomes
  1. Brown Attention Deficit Disorder Scale – Adult Version (BADDS)

  2. Clinical Global Impression Scale‐NIMH (CGI)

  3. Beck Depression Inventory, second edition (BDI‐II)

  4. Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ)

Notes We contacted authors to get the information about random sequence generation and allocation concealment that we included in this table (Virta 2014 [pers comm]).
Study start date: not specified
Study end date: not specified
Funding source: this study was supported by RAY, Finland's Slot Machine Association. Maarit Virta received funding for preparation of this manuscript from the Rinnekoti Research Foundation.
Declarations of interest: the first author report no conflicts of interest in this work.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Comment: the randomisation was done before the study started by raffling/draw lots. The authors had a randomised list of the rehabilitation methods beforehand. They had 4 groups: 1. CBT; 2. computerised training; 3. hypnotherapy; and 4. control. So the list looked like: 2, 1, 1, 3, 4, 1, 4, etc. Then every enrolled participant was assigned to the next group.
Allocation concealment (selection bias) Unclear risk Comment: not described
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Comment: it is not possible to blind personnel in a psychosocial intervention.
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Comment: the independent evaluator was a clinical psychologist who was blind to the actual study group of participants.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Comment: no dropouts
Selective reporting (reporting bias) Low risk Comment: the study protocol is not available, but it is clear that the published reports include all expected outcomes, including those that were prespecified.
Other bias Low risk Comment: there was no evidence of other bias.
Conflict of interest Low risk Comment: the study authors report no conflicts of interest in this work.

ADHD: attention deficit hyperactivity disorder; ANCOVA: analysis of covariance; ASRS: Adult ADHD Self‐Report Scale; CBT: cognitive‐behavioural therapy; CGI‐S: Clinical Global Impressions ‐ Severity; DBT: dialectical behaviour therapy; DSM: Diagnostic and Statistical Manual of Mental Disorders; ITT: intention‐to‐treat; LOCF: last observation carried forward; MBCT: mindfulness‐based cognitive therapy; SD: standard deviation; SH: skills handout; WL: waiting list.