Resumen de Sex differences in the efficacy of cognitive behavioral therapy for adults with attention-deficit/hyperactivity disorder

Juan Jesús Crespín Hombrado, Montserrat Corrales de la Cruz, Vanesa Richarte Fernández, Gemma Parramon Puig, Santiago Biel, Ferran Mestres, Carolina Ramos Sayalero, Pol Ibáñez, Gemma Nieva Rifá, Carla Torrent Font, Derek Clougher, Christian Fadeuilhe Grau, Silvia Amoretti Guadall, Josep Antoni Ramos-Quiroga

• Background and objectives: Cognitive Behavioral Therapy (CBT) is an effective adjunctive treatment for Attention- Deficit/Hyperactivity Disorder (ADHD). This study examined sex differences in the efficacy of a brief 6-session CBT program versus a traditional 12-session format, combined with stable pharmacotherapy, in adults with ADHD.

  Methods: A total of 81 adults (58 % male; 41.27 ± 9.26 years) were randomly assigned to 6- or 12-session CBT.

  ADHD symptoms, psychopathology, and functioning were assessed at baseline, post-treatment, and 3- and 6- month follow-up. Mixed-effects models analyzed interactions between time, treatment group, and sex.

  Results: At baseline, females exhibited greater symptom severity (p = 0.019), higher inattention (p < 0.001), and more pronounced impairments (p = 0.004). CBT led to significant clinical improvements regardless of sex. A significant time-by-sex interaction emerged for inattention (CAARS:O:L, p = 0.043), although it did not remain significant after adjusting for baseline severity. Regarding time × group × sex interactions, females in the 6-ses- sion group showed smaller reductions in clinical severity during follow-up (CGI-S, p = 0.047); however, this effect was no longer statistically significant after controlling for baseline ADHD severity. Findings should be interpreted with caution given the limited female sample at follow-up and the significant influence of initial symptom burden on long-term trajectories.

  Conclusions: CBT improves ADHD symptoms and related impairments in adults, with comparable overall benefits across sexes. Treatment response follow-up differences were better explained by baseline severity and treatment intensity rather than sex-specific differences.