This systematic review brought together 143 intervention studies. Together they covered 22,132 participants. They were adults over 18 with a formal diagnosis under DSM-3, DSM-4 or DSM-5. Most studies were randomized controlled trials, at 101 of the 143. A further 14 compared groups before and after. Another 28 measured one group before and after.
Medication research dominated the set. Drug treatments were the focus of 60.8% of the studies. Psychosocial approaches accounted for 28.7%. The remaining 10.5% combined the two. Reducing core ADHD symptoms was the main outcome in 108 of the 143 studies.
Work settings were almost absent. No study was carried out in a real workplace, apart from two that used a simulated one. Work outcomes were a primary outcome in four studies and a secondary outcome in 11 more. Another 35 studies used measures with subscales touching on work.
Among the four studies focused on work outcomes, those combining medication with psychosocial support reported better functioning at work and maintained employment. The studies of medication alone reported no difference in work productivity and no improvement in occupational status at follow up.
The authors identified mechanisms of effectiveness from the psychosocial studies, including group therapy, involving the person's support network, and the client and patient relationship. Gray literature was excluded. Most studies, 60%, were rated unclear on risk of bias, and the authors cannot rule out that senior, managerial and professional roles were under represented.
Source: Lauder K, McDowall A, Tenenbaum H. A systematic review of interventions to support adults with ADHD at work—Implications from the paucity of context-specific research for theory and practice. Frontiers in Psychology (2022). doi:10.3389/fpsyg.2022.893469