摘要: | Background Till now, there have been various therapies for attention-deficit/hyperactivity disorder
(ADHD), but the previous meta-analysis of ADHD efficacy remains unclear. This study aims to
systemically meta-regress the effect sizes of psychostimulant pharmacotherapy (methylphenidate and
lisdexamfetamine), non-stimulant pharmacotherapy (atomoxetine and alpha-2 agonists), psychosocial
therapy (parental behavioral therapy [PBT]), combination therapy (psychostimulant plus PBT), and
alternative/complementary interventions to determine the right treatment for ADHD. Methods We
searched various ADHD interventions from the MEDLINE and PubMed databases (National Center
for Biotechnology Information) between January 1, 1980 and July 30, 2018. Following the meta-analysis of random effects, the meta-regression analyses were used to explore factors potentially
influencing treatment efficacy. The confounding variables included type of treatment, type of study,
age, type of symptom scale used, and year of publication. Results A total of 107 trials (N = 9883
participants) were included. After adjustment, compared to the psychostimulant therapy (28 trial,
2134 participants), non-stimulant pharmacotherapy (28 trials, 4991 participants) and
alternative/complement intervention (25 trials, 1195 participants) were less effective by the effect
sizes (ES) of -0.384 (p = 0.004) and -0.419 (p = 0.028) respectively. However, compared to
psychostimulant, PBT (19 trials, 1122 participants; ES = -0.308, p = 0.095) and combination of
psychostimulant and PBT (7 trials, 441participants; ES = -0.196, p = 0.209) did not differ
significantly. Conclusions Psychostimulant therapy surpassed non-stimulant pharmacotherapy and
alternative/complement intervention. Psychostimulant therapy, PBT, and combination of
psychostimulant therapy and PBT appear to be similar in efficacy according to this meta-regression. |