Tourjman Valerie, Louis-Nascan Gill, Ahmed Ghalib, DuBow Anaïs, Côté Hubert, Daly Nadia, Daoud George, Espinet Stacey, Flood Joan, Gagnier-Marandola Emilie, Gignac Martin, Graziosi Gemma, Mansuri Zeeshan, Sadek Joseph
Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada.
Department of Psychology, Université du Québec à Montréal, Montreal, QC H2X 3P2, Canada.
Brain Sci. 2022 Aug 1;12(8):1023. doi: 10.3390/brainsci12081023.
Multiple psychosocial interventions to treat ADHD symptoms have been developed and empirically tested. However, no clear recommendations exist regarding the utilization of these interventions for treating core ADHD symptoms across different populations. The objective of this systematic review and meta-analysis by the CADDRA Guidelines work Group was to generate such recommendations, using recent evidence. Randomized controlled trials (RCT) and meta-analyses (MA) from 2010 to 13 February 2020 were searched in PubMed, PsycINFO, EMBASE, EBM Reviews and CINAHL. Studies of populations with significant levels of comorbidities were excluded. Thirty-one studies were included in the qualitative synthesis (22 RCT, 9 MA) and 24 studies (19 RCT, 5 MA) were included in the quantitative synthesis. Using three-level meta-analyses to pool results of multiple observations from each RCT, as well as four-level meta-analyses to pool results from multiples outcomes and multiple studies of each MA, we generated recommendations using the GRADE approach for: Cognitive Behavioral Therapy; Physical Exercise and Mind-Body intervention; Caregiver intervention; School-based and Executive intervention; and other interventions for core ADHD symptoms across Preschooler, Child, Adolescent and Adult populations. The evidence supports a recommendation for Cognitive Behavioral Therapy for adults and Caregiver intervention for Children, but not for preschoolers. There were not enough data to provide recommendations for the other types of psychosocial interventions. Our results are in line with previous meta-analytic assessments; however, they provide a more in-depth assessment of the effect of psychosocial intervention on core ADHD symptoms.
已经开发并通过实证检验了多种治疗多动症症状的心理社会干预措施。然而，对于在不同人群中使用这些干预措施来治疗多动症核心症状，尚无明确的建议。CADDRA指南工作组进行这项系统评价和荟萃分析的目的是利用最新证据得出此类建议。在PubMed、PsycINFO、EMBASE、EBM Reviews和CINAHL中检索了2010年至2020年2月13日的随机对照试验（RCT）和荟萃分析（MA）。排除了合并症水平较高人群的研究。定性综合分析纳入了31项研究（22项RCT，9项MA），定量综合分析纳入了24项研究（19项RCT，5项MA）。我们使用三级荟萃分析汇总每个RCT的多个观察结果，以及四级荟萃分析汇总每个MA的多个结果和多项研究的结果，采用GRADE方法针对学龄前儿童、儿童、青少年和成人人群的多动症核心症状，对认知行为疗法、体育锻炼和身心干预、照顾者干预、基于学校和执行功能的干预以及其他干预措施提出了建议。证据支持对成人采用认知行为疗法，对儿童采用照顾者干预措施，但不建议对学龄前儿童采用。没有足够的数据为其他类型的心理社会干预提供建议。我们的结果与之前的荟萃分析评估一致；然而，它们对心理社会干预对多动症核心症状的影响提供了更深入的评估。
