CBT for anxious children with comorbid ADHD

Attention-de ficit/hyperactivity disorder (ADHD) and anxiety are the most common psychiatric disorders of childhood and are highly comorbid. While cognitive behavioural therapy (CBT) has demonstrated general efficacy in treating paediatric anxiety, it is not clear whether ADHD comorbidity impacts treatment response. While some previous studies have found a negative impact of comorbidity, others have found no difference, and the role of ADHD subtype has never been assessed. We examined ADHD diagnosis as a predictor of treatment response and remission in a study of 842 children and adolescents aged 6 to 18 years undergoing group-based CBT for primary anxiety. A subsample of 94 children met criteria for comorbid, mild-to-moderate ADHD, mostly comprising Predominantly Inattentive(n = 61) and Combined (n = 27) subtypes. Neither ADHD diagnosis nor subtype predicted response or remission rates for children's primary anxiety disorders. Children with ADHD also showed modest yet significant improvements in ADHD symptoms after CBT treatment for anxiety. Our findings strongly support the suitability of manualised group-based CBT for anxiety treatment in children with non-primary ADHD . Further research should examine whether the positive outcomes reported can be extended to children with primary or severe ADHD.