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治疗患有注意力缺陷多动障碍青少年的执行功能:药理学和非药理学干预措施综述

Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions.

作者信息

Wilens Timothy E, Stone Mira, Lanni Sylvia, Berger Amy, Wilson Ronan L H, Lydston Melis, Surman Craig B

机构信息

Massachusetts General Hospital, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

J Atten Disord. 2024 Mar;28(5):751-790. doi: 10.1177/10870547231218925. Epub 2024 Jan 4.

Abstract

INTRODUCTION

Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear.

METHODS

We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD.

RESULTS

Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological ( = 3,576 participants), neurological ( = 1,935), psychological ( = 2,387), digital ( = 2,416), physiological ( = 680), and combination ( = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions.

CONCLUSION

A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary.

摘要

引言

执行功能(EF)缺陷在患有注意力缺陷多动障碍(ADHD)的青少年中很常见,并造成严重的功能损害。针对患有ADHD的青少年的执行功能干预措施的范围和效果仍不明确。

方法

我们使用PRISMA指南进行了一项系统的文献综述。纳入的研究是针对患有ADHD的青少年治疗执行功能的干预措施的随机对照试验。

结果

我们的检索返回了136项研究,涉及11443名研究参与者。我们确定了六种干预类别:非兴奋剂药物治疗(n = 3576名参与者)、神经学治疗(n = 1935名)、心理学治疗(n = 2387名)、数字治疗(n = 2416名)、生理学治疗(n = 680名)和联合治疗(n = 366名)。大部分证据支持药物干预在减轻执行功能方面最有效,其次是心理和数字干预。

结论

对于患有ADHD的青少年的执行功能存在多种治疗方法。药物、心理治疗和数字干预具有最有利、可重复的结果。各研究之间缺乏结果标准化限制了治疗方法的比较。需要更多关于干预效果持续性的数据。

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