TOPLINE

A study found that adults with attention-deficit/hyperactivity disorder (ADHD) receiving psychological therapy for depression and anxiety through the NHS Talking Therapies programme in England had lower odds of reliable recovery and improvement and higher odds of reliable deterioration than matched adults without ADHD.

METHODOLOGY

• Researchers conducted a retrospective cohort study using linked electronic healthcare records of adults who received psychological therapy through NHS Talking Therapies for depression and anxiety in England between 2012 and 2022.
• The study included 13,693 adults with diagnosed ADHD who were compared with propensity score-matched adults without ADHD (n = 3,251,599).
• Outcomes included reliable improvement, recovery, and deterioration following therapy and changes in Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scores. Treatment characteristics included therapy intensity, treatment completion, referral to other services, and therapy suitability. 

TAKEAWAY

• After propensity score matching and adjustment for covariates, adults with ADHD had lower odds of reliable improvement (odds ratio [OR], 0.77; 95% CI, 0.73-0.81) and reliable recovery (OR, 0.69; 95% CI, 0.65-0.72) than those without ADHD.
• Adults with ADHD had higher odds of reliable deterioration than matched adults without ADHD (OR, 1.38; 95% CI, 1.25-1.50).
• They also showed moderate-to-large reductions in both depression and anxiety symptoms after psychological therapy (Cohen's d average, -0.72 for both outcomes).
• Moreover, adults with ADHD were more likely to discontinue therapy early and to be referred to other services or considered unsuitable for NHS Talking Therapies than those without ADHD.

IN PRACTICE

"Findings suggest that such interventions may be provided in non-specialist mental health services but highlight a need for evidence-based guidance for clinicians to adapt therapy for people with ADHD which could consider both strengths and difficulties associated with living ADHD," the authors wrote.

SOURCE

The study was led by Celine El Baou, Clinical, Educational and Health Psychology, University College London, London, England. It was published online on August 06, 2026, in The Lancet Regional Health - Europe.

LIMITATIONS

The study was limited by its observational design; missing covariate data; the absence of detailed information on ADHD medication use, non-pharmacologic support, and presentation; and the likely underdiagnosis of ADHD, particularly among older adults, women, and ethnic minority groups.

DISCLOSURES

The study was funded by the Medical Research Foundation. Several authors reported receiving research funding, payments, or honoraria or having other relationships with academic institutions, charities, healthcare organisations, and pharmaceutical companies. Full disclosures are available in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.