Yu Shuxin, Xue Hui, Xie Yuqing, Shao Guanyue, Hao Yihui, Fan Lijun, Du Wei
School of Public Health, Southeast University, Nanjing, China.
Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
Child Adolesc Ment Health. 2025 Feb;30(1):34-52. doi: 10.1111/camh.12744. Epub 2025 Jan 10.
Animal-assisted interventions (AAIs) have emerged as a promising nonpharmacological intervention option for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, recent systematic reviews have been primarily narrative. Additionally, the pooled effectiveness of AAIs was absent from these systematic reviews.
We conducted a comprehensive systematic review and meta-analysis, searching multiple databases, including Web of Science, MEDLINE, CINAHL, Scopus, PsycINFO, EMBASE and Cochrane, from inception of the databases to March 2024. We retrieved 17 randomised controlled trials or quasi-experimental studies and used Review Manager 5.4.1 software to perform a meta-analysis of the effects of AAIs in treating children with ADHD. We conducted a set of random-effects meta-analyses to estimate standardised mean differences (SMD) with 95% confidence intervals (CI) using subgroup data by different outcome domains extracted from eight randomised controlled trials, in relation to changes in behavioural, mental and physical functioning in a total of 307 children with ADHD before and after the intervention.
In comparison with non-AAI groups, AAIs significantly improved attention problems in children with ADHD (SMD = -0.42, 95% CI = -0.71 to -0.13), self-esteem (0.46, 0.14 to 0.78), learning and cognition problems (-0.69, -0.98 to -0.39) and motor proficiency (0.77, 0.11 to 1.42). The pooled effect of AAIs on the severity of ADHD symptoms in the experimental group was not significantly different from the effect of conventional treatments in the control group (0.10, -0.31 to 0.52). Similarly, AAIs had no significant positive effects on social interaction (-0.22, -0.51 to 0.06), social skills (-0.32, -0.87 to 0.24), problematic behaviours (-0.10, -0.54 to 0.35) or emotional problems, including depression and anxiety (-0.13, -0.51 to 0.24).
As an ADHD management strategy complementary to gold-standard approaches, such as medication or multimodal interventions, AAIs did not appear to be more effective in improving the majority of core ADHD outcomes in children. Future studies should incorporate rigorous study designs with large sample sizes and a standard protocol to achieve more valid and reliable conclusion.
动物辅助干预（AAIs）已成为一种有前景的非药物干预选择，用于治疗被诊断为注意力缺陷多动障碍（ADHD）的儿童。然而，最近的系统评价主要是叙述性的。此外，这些系统评价中缺乏AAIs的综合有效性。
我们进行了一项全面的系统评价和荟萃分析，检索了多个数据库，包括Web of Science、MEDLINE、CINAHL、Scopus、PsycINFO、EMBASE和Cochrane，从数据库建立之初到2024年3月。我们检索到17项随机对照试验或准实验研究，并使用Review Manager 5.4.1软件对AAIs治疗ADHD儿童的效果进行荟萃分析。我们进行了一组随机效应荟萃分析，以估计标准化均数差（SMD）及其95%置信区间（CI），使用从8项随机对照试验中提取的不同结局领域的亚组数据，涉及307名ADHD儿童干预前后行为、心理和身体功能的变化。
与非AAI组相比，AAIs显著改善了ADHD儿童的注意力问题（SMD = -0.42，95%CI = -0.71至-0.13）、自尊（0.46，0.14至0.78）、学习和认知问题（-0.69，-0.98至-0.39）以及运动能力（0.77，0.11至1.42）。AAIs对实验组ADHD症状严重程度的综合效应与对照组传统治疗的效应无显著差异（0.10，-0.31至0.52）。同样，AAIs对社交互动（-0.22，-0.51至0.06）、社交技能（-0.32，-0.87至0.24）、问题行为（-0.10，-0.54至0.35）或情绪问题（包括抑郁和焦虑）（-0.13，-0.51至0.24）没有显著的积极影响。
作为一种与药物治疗或多模式干预等金标准方法互补的ADHD管理策略，AAIs在改善儿童大多数核心ADHD结局方面似乎并不更有效。未来的研究应采用严谨的研究设计和大样本量以及标准方案，以得出更有效和可靠的结论。
