1 National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil.
CNS Spectr. 2013 Dec;18(6):296-306. doi: 10.1017/S109285291300031X. Epub 2013 Jun 6.
OBJECTIVE/INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) in adult life is a prevalent condition. We systematically reviewed the literature available by searching for meta-analyses assessing pharmacological and psychosocial interventions for adults with ADHD.
Using wide-ranging search terms, we retrieved 191 titles from the PubMed and Cochrane databases. Two independent evaluators judged all abstracts. Only meta-analyses about the treatment of adults with ADHD were included. Information from meta-analyses found was systematically extracted by 3 independent evaluators.
Eight meta-analyses were identified. Results from those meta-analyses suggest that stimulants are effective in decreasing ADHD symptoms on a short-term basis with a medium to large effect size (ES). Short-acting stimulants might be superior to long-acting stimulants, but no data on difference in adherence are available for the comparison of these two types of formulation. Bupropion is superior to placebo but less effective than stimulants. No conclusions about the impact of psychosocial interventions can be drawn based on meta-analyses so far. Discussion The efficacy of stimulants in reducing ADHD symptoms for adults is well documented in meta-analyses, but there is a concerning lack of meta-analysis about other treatment interventions.
The available meta-analytic literature does not cover questions of essential clinical relevance for adults with ADHD.
目的/介绍:成人注意缺陷多动障碍(ADHD)是一种普遍存在的疾病。我们通过搜索评估成人 ADHD 药物和心理社会干预的荟萃分析,系统地回顾了现有文献。
使用广泛的搜索词,我们从 PubMed 和 Cochrane 数据库中检索到 191 个标题。两名独立评估员评估了所有摘要。仅纳入关于成人 ADHD 治疗的荟萃分析。由 3 名独立评估员系统地提取荟萃分析中发现的信息。
确定了 8 项荟萃分析。这些荟萃分析的结果表明,兴奋剂在短期基础上有效减少 ADHD 症状,具有中到大的效应量(ES)。短效兴奋剂可能优于长效兴奋剂,但对于这两种配方的比较,尚无关于顺应性差异的数据。安非他酮优于安慰剂,但不如兴奋剂有效。到目前为止,基于荟萃分析还无法得出关于心理社会干预影响的结论。讨论:荟萃分析清楚地证明了兴奋剂在减少成人 ADHD 症状方面的疗效,但关于其他治疗干预措施的荟萃分析却很少。
现有荟萃分析文献未涵盖成人 ADHD 患者基本临床相关问题。